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Buyer Questionnaire

Contact Information
Firm Name:
Address:
City:
State: Zip:
Contact:
Title:
Phone:
Fax:
Cell Phone:
Email:
Web Site:

Acquisition Criteria
Minimum Sales:
Minimum EBITDA:
Maximum Sales:
Maximum EBITDA:

Acquisition Criteria Comments:

Geographical Preference
Northeast:
spacer CT MA ME NH NJ NY PA RI VT
Southeast:
spacer DC DE FL GA MD NC SC VA WV
South Central:
spacer AL KY MS TN
Southwest:
spacer AR OK LA TX
Midwest:
spacer IA IL IN KS MI MN MO ND NE OH SD WI
West:
spacer AZ CA CO ID MT NM NV OR UT WA AK HI

spacer All 50 States

Geographical Preference Comments:

Industry Preference
Healthcare Services  
Behavioral Health  
Healthcare Staffing: Allied Locum Tenen Per Diem Travel Recruiting
Home Health Care: Medicare Certified Private Duty Medicaid
Home Medical Equipment  
Hospice  
Infusion Therapy  
Long Term Care (Institutional) Pharmacy
Pharmacy Distribution (Distribution of pharmaceuticals to specialty pharmacies and other healthcare
providers)
Specialty Pharmacy (direct to patient, mail order, or other provision of specialty drugs; ie, IVIG, Synagis, Remicaid, Growth Hormones, etc.)
Technology  
Health Care Information Technology
Other Areas of Acquisition Interest
Other:

Industry Preference Comments:

Financing Information
Source:
 Committed Funds / Cash on Hand Pledged Funds to be Raised

Fund Size:

< $10MM $10-50MM $50-100MM $100-500MM >$500MM


Portfolio Companies in Healthcare Services/Technology Sectors:

Financing Information Comments:

Additional Comments
The Braff Group, 1665 Washington Road, Suite 3, Pittsburgh, PA 15228