Appraisal Quotation Form All information gathered remains CONFIDENTIAL. We will be pleased to quote our PRACTICE APPRAISAL FEE upon receipt of this information. Appraisal Quotation Form About Your Practice Practice Name * Practice Address * Unit / Suite # City/Town * Province * Province Alberta British Columbia Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland Yukon Territory Northwest Territories Nunavut Postal Code * Square Footage * # of Operatories/Exam Rooms * # of Operatories/Exam Rooms 0 1 2 3 4 5 6 7 8 9 10 + # of Associates * # of Associates 0 1 2 3 4 5 6 7 8 9 10 + Gross Revenue * Gross Revenue Under $250,000 $250,000 - $500,000 $500,000 - $750,000 $750,000 - $1,000,000 $1,000,000 - $2,500,000 $2,500,000 - $5,000,000 $5,000,000 and up Do you own the building? * Yes No Are you Incorporated? * Yes No Do you have partners? * Yes No Best time to visit? Best time to visit? Not sure Weekend Weekdays Evenings Any other relevant information About You Title * Title Dr. Mr. Ms. Mrs. First Name * Last Name * Confidential Phone * Confidential Email * Confidential Address * Unit / Suite City/Town * Province * Province Alberta British Columbia Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland Yukon Territory Northwest Territories Nunavut Postal Code * Profession * Profession Dental Veterinary Optometry Other Specialty Other Profession University * Graduation Year * Select an Associate Select an Associate Select Bill Alton John Badger Marcia Boyd Andrew Bryson Lance Edwards Doron Eisenberg Roger Ellis Scott Green Pascale Guillon Roopali Kapoor Amanda Kotchie Robert MacDonald Dev Mangat David Raborn Wayne Raborn David Rourke Cathy Scott Reema Singla Rob Spillane Alexis Sweetnam Raymund Torres Jeff Williams Ann Wright How should we contact you? How should we contact you? Email Phone Mail Purpose of your Appraisal? * Purpose of your Appraisal? Planning Incorporation Sale Associate Buy-in Insurance Matrimonial Other How did you hear about us? * How did you hear about us? Website Google Seminar Convention Referral Past Client Oral Health Ontario Dentist Just For Canadian Dentist The Bridge (BC Dental Association) Dental Bits and Bites (Newfoundland Dental) Nova Scotia Dentist New Brunswick Bulletin Profitable Practice Magazine Updater (Alberta) The Capital Examiner (Ottawa) CDSS News (Saskatchewan) MDA Bulletin (Manitoba) Ordre des dentists du Quebec Canadian Vet Practice Focus (OVMA) Veterinary Practice News Other I understand that by clicking Yes, I agree to receive more information from ROI Corporation. Yes No Submit If you are human, leave this field blank.