ChiroEdge Legacy Program — Confidential Practice Valuation

What is your practice worth?

Complete this short questionnaire and we'll prepare a preliminary value range before your first advisor consultation — at no cost and no obligation.

lock Strictly confidential
schedule 10–15 minutes
check_circle No cost · No obligation
star Advisor follow-up within 2 business days

1 About you
2 Financials
3 Revenue mix
4 Operations
5 Facility
6 Your goals
7 Submit

Step 1 of 7 — About you

About you & your practice

Basic contact information. This is never shared with potential buyers without your explicit written permission.

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Your privacy is protected. This questionnaire is confidential and used solely to prepare your preliminary valuation. ChiroEdge does not share your information with any third party without your permission.

First name *

Last name *

Practice name *

Email address *

Best phone number *

Practice state *

City / ZIP

Years in practice

Preferred contact method

How did you hear about ChiroEdge?

Financial overview

Estimates are fine at this stage — your advisor will review actual documentation during the formal valuation. These figures help us generate your preliminary range before your first call.

insights

Why we ask: Practice value is primarily driven by adjusted profitability — not gross revenue alone. These figures are used only to calculate your estimated value range and are kept strictly confidential.

Your practice financials

Annual gross collections — last 12 months *

What was actually collected — not billed.

Annual overhead expenses *

All expenses excluding your own compensation.

Your annual compensation from the practice *

W-2 salary plus any owner distributions or draws.

Other non-recurring add-backs

One-time costs not expected to recur.

Financial records & revenue trend

Financial records available for review?

Yes — CPA-prepared P&L or tax returns Strongest documentation for valuation — preferred by buyers and lenders Yes — in-house records (QuickBooks, etc.) Acceptable at this stage; CPA review recommended before a deal closes Not yet We can still prepare an estimate — records will be needed before a formal engagement Not sure what I have

How would you describe your collections over the past 3 years? *

Growing — up 10% or more per year Strong upward trajectory — premium multiple range Growing — modest or steady increase (5–10%) Healthy growth — above-average multiple Stable — roughly flat At-market multiple — consistent practices still transact well Declining slightly Applies a modest discount — common and often addressable Declining significantly Compresses the multiple — your advisor will discuss strategies

Revenue & payer mix

How your collections are divided across payer types significantly affects your practice's value and the multiples buyers apply.

Payer mix

Roughly what share of your collections comes from each payer type? These are broad bands — estimates are fine.

warning

Note on personal injury revenue: PI cases above 30% of collections typically compress valuation multiples because this revenue is contingent on case settlement and non-recurring. This isn't disqualifying — your advisor will walk through it with you.

Cash pay & membership

Self-pay, wellness, membership care.

Personal injury (PI)

Auto, slip-and-fall, litigation.

Insurance (non-PI)

Commercial — Blue Cross, Aetna, United.

Practice orientation & government programs

Practice is primarily

Medicare status *

Participating — enrolled and in-network Nonparticipating — enrolled, out-of-network Not enrolled — I do not treat Medicare patients

If enrolled — % of collections from Medicare

Accept Medicaid?

ChiroEdge Legacy Program

Practice Transition Questionnaire · CONFIDENTIAL

Preliminary value range estimate

Adj. EBITDA

EBITDA multiple

Collections mult.

Assessment

Industry floorIndustry ceiling

Financial summary

Revenue & payer mix

Practice operations

Valuation quality factors

Factor	Assessment	Impact

Facility & equipment

Transition goals

Methodology

Estimated using two methods: (1) EBITDA multiple anchored at 2.5× adjusted for quality factors and payer mix; (2) collections multiple anchored at 1.3×. Range widened ±8% for negotiation variance. Real estate at FMV. Equipment at 60% of replacement cost.

ChiroEdge Legacy Program · Powered by the Michigan Association of Chiropractors · This document is for advisory purposes only and does not constitute a formal appraisal, legal opinion, or offer to purchase. Confidential. · info@chiro-edge.com · (517) 619-1290 · chiro-edge.com

What is your practice worth?

About you & your practice

Financial overview

Revenue & payer mix

Practice operations

Facility & equipment

Your transition goals

Almost done

ChiroEdge Legacy Program