I,
, hereby acknowledge and agree that all information pertaining to practice(s) that I am introduced to by ROI Corporation, shall be obtained only through ROI Corporation, and that I WILL NOT CONTACT THE OWNER(S), STAFF, PATIENTS, or other advisors of the
practice(s), unless I am ACCOMPANIED BY AN ASSOCIATE OF ROI CORPORATION, the Exclusive
Agent for the Vendor(s). I further agree not to write or mark the Appraisal(s), nor shall I copy or reproduce
any information in any manner whatsoever without the prior consent of ROI Corporation.
I understand and agree that any information supplied to me is as a SERIOUS PROSPECTIVE PURCHASER and that all information, including the VENDOR'S NAME, the location of the practice, financial details, and
all other information pertaining to the practice and its operation, are STRICTLY CONFIDENTIAL and for my
own personal use, and with prior consent from ROI Corporation, for use with my accountant, bank and or other
financial institution for the purpose of assessing the viability of acquiring said practice and for obtaining funds
for such acquisition. I will inform these parties of this agreement of confidentiality before disclosing the
information supplied.
I acknowledge and agree that all negotiating, drafting and presentations of offers shall be handled through ROI Corporation, as AGENT FOR THE VENDOR, on ROI Corporation's standard offer documentation and that
my lawyer will be provided with a copy of said offer(s) for review prior to my signature.
Date:
Name:
Confidential Telephone No.: (
)
Fax No.: (
)
E-Mail Address:
Confidential Address:
Year Graduated: University:
Where do you want to practise?
I am a:
Associate
Principal
Student
I am a:
General Dentist
Specialist (
- type)
ROI Corporation hereby acknowledges and agrees that any information of a professional, personal or financial nature
provided by the above signed, including their desire to acquire an interest in, or has had discussions about, a professional
practice, shall be held in strict confidence by ROI Corporation.
ROI Corporation is compliant with PIPEDA effective January 1st, 2004.
