WITH REGARD TO THE DENTAL PRACTICE OF:
DR. _____________
May this document serve as good and sufficient notice to my family and
/or Executors that, in the event of my death or disability which renders
me unable to operate my dental practice, I hereby instruct you to arrange
for the immediate appraisal and sale of my dental practice.
This service will be performed by ROI Corporation, Professional Practice
Appraisers and Brokers, 1155 Indian Road, Mississauga, Ontario, L5H 1R8, (905) 278-4145.
ROI Corporation is to be engaged to perform their services of practice
Appraisal and Brokerage at their usual fees and in their customary manner.
ROI Corporation will make their best efforts to arrange for a compatible
Locum to operate my practice until the day of closing of the sale. The
Locum will be contracted by means of a standard Locum Agreement, which
will include a provision for NON-Competition and NON-Solicitation for the
protection of my practice goodwill.
I understand that should it be necessary to sell my practice immediately,
an appraisal is to be updated or performed as quickly as possible and I
instruct my family and/or Executors to provide all relevant information
required by ROI Corporation in a timely manner. I understand that my practice
will be advertised for sale to obtain its highest possible value for me
or my estate.
I have executed this document today in duplicate in the presence of a witness
and I have sent one copy to ROI Corporation and/ or my Lawyer and a second
copy is kept with my will.
Signed this _____ day of _______________, 200__.
Full Legal Name: ______________________________________________
(please print)
Witness: _________________________ Signature: _________________________
Please consult with your advisors for estate matters, per: Timothy A. Brown,
President, ROI Corporation
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