CONFIDENTIALITY AGREEMENT

In connection with the possible acquisition by you of the business of       _____________________________________.  We will furnish you information regarding the business, financial condition and operations of the practice.  In consideration of obtaining this proprietary information, you agree that:

1.                  All proprietary information furnished by us or the Seller/Owner to you will be received and treated as confidential.  The term proprietary information does not include any information which is, or becomes, generally available to the public or is already in your possession.

2.                  Unless we otherwise agree in writing, for five years from this date, you will not disclose or reveal any proprietary information to any person(s) or entity(s) other than representatives of yours who are directly participating in the evaluation of the information for any purpose other than in connection with this transaction.

3.                  If you decide that you do not wish to pursue the proposed transaction, you will advise us of this fact and deliver to us all the proprietary information furnished to you without keeping copies.

4.                  Although you understand that both the Seller/Owner and we have included in the proprietary information certain information which we consider to be relevant for the purpose of your investigation, we do not make any representation or warranty as to its completeness.

5.                  The proposed Seller of the business has an interest in keeping the fact of the offering of the business for sale confidential.  As a prerequisite to the exposure of the identity, any facts, statistics, and/or public dissemination of the information revealed is absolutely prohibited.  Such information is to remain strictly confidential, and by accepting the information for review and consideration, you agree to abide by such required confidentiality.  Failure to do so my result in the pursuit, by the Seller, of any and all available claims for reputational damage, and/or impairment; interference with prospective business advantage; interference with business expectations; and/or any similar claims which might be warranted based upon such disclosure.

If you are in agreement, please complete this form and indicate your acceptance through signature.

_____________________________________Signature

_____________________________________Date

_____________________________________Name

_____________________________________Address