Practice Summary

Personal Details

Principal Dentist First Name
Principal Dentist Last Name
Mobile Number
Phone Number
Date of Birth
Email Address
Preferred Method of Contact

Practice Details

Practice Name
Practice Phone Number
Practice Address
Practice Email Address
Years Practice has been in operation

Number of Surgeries

Years as Practice Owner

What Practice Management software is used?
Years Practice has been at current address

Registered Business Name

Practice Opening Details


Financial Details

Year to Date Revenue
Previous Financial Year Revenue
What is your remuneration for associates?
How do you engage your associates (contract/employment agreement)?
Do you lease or own the premises?
Lease Duration

Number of Employees

Practice Manager
Dental Assistant
Once we progress from the basics, we will need a full picture of the practice and this will include most of the items below.

Profit and Loss

  • Financial (statutory) accounts for the last completed financial year.
  • Management accounts for subsequent trading period.

Commentary on Profit and Loss

  • Annual gross revenue by practitioner, including the practice principal, associate dentists, specialists,  oral  health therapists and hygienists.
  • Laboratory fees by practitioner for the same period as revenues in point above.
  • Please identify any personal, non-recurring items of expenditure or purchases of equipment.


  • List of current staff with annual salary and typical expenditure on casual/temp staff.
  • List of associate dentists and remuneration agreements with them.


  • Copy of premises lease including rent payable, term and options, rental increase provisions and contributions to outgoings.