Contact Info & Buyer Profile Form

American HealthCare Capital provides sellers with comprehensive medical business services and representation, guiding them through each step of the sale process.

Please fill out the medical and healthcare company buyer profile form below. The information you submit on the form will be used to prequalify you for every listing you sign an NDA for, so please make sure to fill it out as thoroughly and accurately as possible. Information about your current locations of operation, funding, and healthcare acquisition experience are extremely important for our preapproval process and will determine whether we can share additional information on our listings. Please note that many of our listings require seller preapproval before the CIM can be shared, and we always require pre-approval for in-state buyers. If anything changes after you have completed this form, please feel free to reach out to us to provide the most current information. If you have any questions or need assistance, please contact us at (310) 437-4422 or email jacquelyn@ahcteam.com.

**PLEASE ONLY COMPLETE THIS FORM ONCE UNLESS YOU NEED TO UPDATE THE INFORMATION IN YOUR PROFILE. IT DOES NOT NEED TO BE COMPLETED EVERYTIME AN NDA IS EXECUTED.**

"*" indicates required fields

Contact Information

Name*

First Last

Title*

Email*

Office Phone*

Mobile Phone

Buyer Profile

I will be reviewing listings on behalf of:*

Brief Company Background and Description of Your Business*

A few sentences about your company including the history of the business and what services are provided.

Please give a description of your or your team's relevant healthcare experience.*

Amount of Capital Available Before Financing*

Please use numbers only.

Do you plan to purchase a business with cash or financing, or both? Please elaborate.*

Please provide your source of funding.*

(eg. Will you be self-funding? Are you backed by a private equity group? Will you be getting financing from a bank?)

Do you or your company own or have investments in any healthcare companies?*

Please list the names of the healthcare companies and the states they are operating in.

Have you made any recent acquisitions in healthcare? Please give a description of the company type(s) and size(s).*

Range of Preferred Acquisition Size

Any additional acquisition criteria you want to share?

Email Notifications

Please select the categories for the types of listings you would like to receive email notifications about.

All Categories

Adult Day Care

Alcohol and Substance Abuse & Recovery

Assisted Living Facilities

Behavioral Health, Mental Health, & ABA Therapy

Billing, Collections, & Revenue Cycle Management

Clinical Trials & Research

Clinics, Urgent Care, & Emergency Rooms

Consultants, Care Management, & Fiduciary

Dental Labs

Dental Practices

Dialysis Centers

DME & HME

Funeral Homes, Cemeteries, & Crematoriums

Health & Wellness

Hearing & Audiology

Home Care & Home Health

Home Infusion

Hospice

Hospitals & Surgery Centers

I/DD and Group Homes

Medical & Dental Supply Distributors

Medical Devices & Manufacturers

Medical Labs

Medical Marijuana

Medical Office Buildings & Other Real Estate

MRI & Imaging

Optometry & Ophthalmology

Orthotics & Prosthetics

Other

Pediatrics

Pharmaceuticals & Supplements

Pharmacy

Primary Care, Pain Management, & Specialty Group Medical Practices

PT, OT, ST, Rehab, & Chiropractors

Skilled Nursing Facilities

Sleep Labs

Software & Technology

Staffing

Telemedicine

Transportation

Veterinary

Women's Health

Wound Care

CAPTCHA

"*" indicates required fields

Contact Information

Name*

First Last

Title*

Email*

Office Phone*

Mobile Phone

Buyer Profile

I will be reviewing listings on behalf of:*

Brief Company Background and Description of Your Business*

A few sentences about your company including the history of the business and what services are provided.

Please give a description of your or your team's relevant healthcare experience.*

Amount of Capital Available Before Financing*

Please use numbers only.

Do you plan to purchase a business with cash or financing, or both? Please elaborate.*

Please provide your source of funding.*

(eg. Will you be self-funding? Are you backed by a private equity group? Will you be getting financing from a bank?)

Do you or your company own or have investments in any healthcare companies?*

Please list the names of the healthcare companies and the states they are operating in.

Have you made any recent acquisitions in healthcare? Please give a description of the company type(s) and size(s).*

Range of Preferred Acquisition Size

Any additional acquisition criteria you want to share?

Email Notifications

Please select the categories for the types of listings you would like to receive email notifications about.

All Categories

Adult Day Care

Alcohol and Substance Abuse & Recovery

Assisted Living Facilities

Behavioral Health, Mental Health, & ABA Therapy

Billing, Collections, & Revenue Cycle Management

Clinical Trials & Research

Clinics, Urgent Care, & Emergency Rooms

Consultants, Care Management, & Fiduciary

Dental Labs

Dental Practices

Dialysis Centers

DME & HME

Funeral Homes, Cemeteries, & Crematoriums

Health & Wellness

Hearing & Audiology

Home Care & Home Health

Home Infusion

Hospice

Hospitals & Surgery Centers

I/DD and Group Homes

Medical & Dental Supply Distributors

Medical Devices & Manufacturers

Medical Labs

Medical Marijuana

Medical Office Buildings & Other Real Estate

MRI & Imaging

Optometry & Ophthalmology

Orthotics & Prosthetics

Other

Pediatrics

Pharmaceuticals & Supplements

Pharmacy

Primary Care, Pain Management, & Specialty Group Medical Practices

PT, OT, ST, Rehab, & Chiropractors

Skilled Nursing Facilities

Sleep Labs

Software & Technology

Staffing

Telemedicine

Transportation

Veterinary

Women's Health

Wound Care

CAPTCHA

Contact Info & Buyer Profile Form

Contact Information

Company Information

Buyer Profile

Email Notifications

Contact Information

Company Information

Buyer Profile

Email Notifications

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