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Buyer Questionnaire
After completing this questionnaire, please click on “Submit” button at bottom of page

Contact Information
Company Name:
Address:
City:
State: Zip:
Contact:
Title:
Phone:
Direct Phone:
Cell Phone:
Email:
Web Site:

Acquisition Criteria
Minimum Sales:
 
Maximum Sales:
 

Acquisition Criteria Comments:


Geographical Preference:
[CLICK ON STATES TO SELECT]

Northeast:
CT MA ME NH
NJ NY PA RI
VT

Southeast:
DC DE FL GA
MD NC SC VA
WV

South Central:
AL KY MS TN

Southwest:
AR OK LA TX

Midwest:
IA IL IN KS
MI MN MO ND
NE OH SD WI

West:
AZ CA CO ID
MT NM NV OR
UT WA AK HI
WY

All 50 States
   

Geographical Preference Comments:

Industry Preference
Healthcare Services  
Home Health & Hospice: Medicare-Certified Pediatric Private Duty Medicaid / Waiver
Hospice
Pharmacy: Infusion Therapy RX Distribution RX Institutional RX Retail
Specialty Pharmacy Compounding PBM Mail Order RX
Home Medical Equipment: Durable Equipment / Oxygen Supplies Sleep Diagnostics
Mobility Diabetic Supplies
Healthcare Staffing: Allied Locums Per Diem Placement Travel
International
Behavioral Health &
Social Services:
Intellectual or Developmentally Disabled At Risk Youth / Child Welfare Acquired Brain Injury Adult Mental Health Welfare to Work
Addictions / Substance Abuse Autism
Other Services: Healthcare Information Technology
Other Areas of Acquisition Interest
Other:

Industry Preference Comments:


Financing Information
Interest as Minority Investor: Yes No


List Past Portfolio Companies in Health Care Service Sectors:

List Present Portfolio Companies in Health Care Service Sectors:

Financing Information Comments:

Additional Comments

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