Address:
  Gary N. Wiessen
34 East Main Street #211
Smithtown, NY 11787
Phone:
  631-281-2810
Fax:
  631-395-1224
 
  gwiesseninfo@buysellpractices.com
     
     
  I understand that you may simply be thinking about the possibility of buying or selling a practice sometime in the future. Your information is considered to be strictly confidential and, without your personal approval, will not be discussed nor disclosed to any party. Also, there is no charge for an inquiry with regard to my services.  



Contact Qustionaire:
Please fill out the form below for more information:
Name:
   
Home Phone :
   
Cell Phone:
   
Email Address:
   
Best Time to Call:
   
Your profession or Specialty:
   
Your Sub-specialty:
   
How long you have been practicing?
   
Where do you wish to practice?
 
1st Choice:
 
2nd Choice:
 
3rd Choice:
 

 
Are you considering:
   
Any Other Comments?
   
If you are Selling your Practice      
Why are you selling?
   
When would you like to leave your practice?
   
Have you appraised or marketed your practice?
  Yes No  
 
 
©2008 Gary N. Wiessen. All rights reserved