I hereby request to be added to The Dental Broker Team distribution list and I further agree to sign a Confidentiality Agreement relating to the Confidential Provisions of Information. The Confidentiality Agreement will be sent under separate email.

Said Confidentiality Agreement will outline that all information pertaining to practice(s) that I am introduced to by The Dental Broker Team, shall be obtained only through The Dental Broker Team, and that I WILL NOT CONTACT THE OWNER(s), STAFF or PATIENTS, or other advisers of the practice(s), unless I am Accompanied by a representative of The Dental Broker Team.

I understand and agree that any information supplied to me is as a Serious Prospective Purchaser and that all information pertaining to the practice and its operation, are STRICTLY CONFIDENTIAL and for my own personal use and with prior consent from The Dental Broker Team, for use with my accountant, Bank and or other financial institution. I will inform these parties of the Agreement of Confidentiality before disclosing the information supplied.

Please ensure that all contact information provided is confidential.