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 $500,000 $500,000 - $1,000,000 $1,000,000 - $1,500,000 $1,500,000 - $2,000,000 $2,000,000 - $3,000,000 $3,000,000 - $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 Any Associate Ontario - Timothy A. Brown Ontario - Jackie Joachim Ontario - Ann Wright Ontario - Bill Alton Ontario - Robert MacDonald Ontario - Rob Spillane Ontario - Alexis Sweetnam Ontario - Amanda Kotchie Ontario - Doron Eisenberg Ontario - Roopali Kapoor Ontario - Constance Oly Ontario - Nicholas Boyle Ontario - Dr. Drew Markham British Columbia - Dr. Marcia Boyd British Columbia - Elliott Broad Alberta - Dr. Wayne Raborn Alberta - David Raborn Alberta - Karl Schmidt Alberta - Dr. Malar Kalia MN and Sask - Reema Singla Atlantic Canada - Dr. Jeff Williams Atlantic Canada - Dr. Andrew Bryson Atlantic Canada - Dr. Scott Green Quebec - Pascale Guillon Quebec - Dr. John Badger Optometry - Lance Edwards Opto & Vet - Roopali Kapoor Other Select an Associate 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 If you are human, leave this field blank. Submit Δ