NewOfficeFinancing.com - Funding Ophthalmic Dreams & Reality

NewOfficeFinancing.com

If you’re starting a new ophthalmic office, showroom, lab or optical dispensary or bringing your existing office into the 21st century then you have a lot of decisions to make. Let NEW OFFICE FINANCING.COM, the experienced ophthalmic funding connection, help you professionally finance your eye care enterprise with the most seasoned consultants and competitive rates. Learn More...…

If you’re starting a new ophthalmic office, showroom, lab or optical dispensary or bringing your existing office into the 21st century then you have a lot of decisions to make. Let NEW OFFICE FINANCING.COM, the experienced ophthalmic funding broker, help you professionally finance your eye care enterprise with the most seasoned consultants and competitive rates.

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Client Information:

Client Name: *

Firm Name:

Address: *

City: *

State: *

Zip Code: *

Office Phone: *

Cell Phone:

Home Phone:

E-Mail Address: *

Best Time to Contact You:

Best Way to Contact You:

Phone Email

Website:

Is This Project Confidential?

Yes No

Submitted By:

Date Submitted:

Purchasing Profile:

Is Your Project: (check all which apply)

New Office (1st Time)	Satellite Office (2nd +)	Renovation
Relocation	Expansion	New Equipment Purchase
Real Estate	Acquisition / Buy Out	Debt Consolidation
Additional Working Capital

Amount You Are Seeking in Total Funding:

Desired Term to Lease:

Time Frame Funds Will be Needed:

Pro Forma Financing Requirements List:

Purchase For:	Preferred Vendor:	Estimated Amount $:
Waiting / Office Seating
Pretest / Diagnostic Equip.
Exam Room Chairs, Stands & Desks
Optical Displays & Furniture
Optical Lab Equipment
Frame Suppliers
Practice Management Software
Filing Systems / Computer Needs
Patient Education Software
Construction Costs
Working Capital Needs
Other

	Total Funding Required:

Practice Profile:

Staff:

# of Ophthalmologists:

# of Optometrists:

# of Opticians:

Location:

# of Locations You Have:

Years in Business:

Type of Building Office is Located In:

Strip Center	Free Standing Building	Hospital
House	Multi-Specialty Clinic	Office Building

Office Size (sq. ft.):

Number of Rooms for:

Diagnostic / Screening :

Exams

Do You Have an Optical Dispensary?:

Yes No

Do You Have the Following Optical Lab?:

Adjustment Lab

Finishing Lab

Surfacing Lab

Do You Have an On-Site
LASIK Suite?:

Yes No

Thank You for completing our preliminary questionnaire.

Please contact me within 24 hours to proceed with financing.

Please click “Submit / Contact Me For Further Discussion”
A Leasing Specialist will contact you with to discuss your project funding needs and a brochure will be sent to you.

Thank you for your interest in NewOfficeFinancing.com.

NewOfficeFinancing.com