Confidentiality & Disclosure Agreement

* fields with an asterisk are required

Your First Name: *		Your Last Name: *
Your Phone Number: *		Your Email Address: *
Address:*		Address two:
City:*	State: *	Zip:*
University Attended:	Year Graduated:

In which state is the practice you're interested in?

SIMMONS & ASSOCIATES, INC., OR ANY LICENSEE, hereinafter referred to SIMMONS & ASSOCIATES, in connection with the possible acquisition of the veterinary practice disclosed, will furnish proprietary information which may include the financial condition, operations, and prospects for future growth. In consideration for SIMMONS & ASSOCIATES providing information relative to the veterinary practice known as LISTING # * , I hereby agree as follows:

1. Not to reveal to anyone, except immediate advisory and fiduciaries, that the veterinary practice disclosed by SIMMONS & ASSOCIATES is for sale, and to ask immediate advisors and fiduciaries to respect this Non-Disclosure and Confidentiality Agreement.

2. All proprietary information furnished will be deemed confidential except information which is generally available to the public or is already in my possession. The information presented will not be used in any way for personal benefit other than the purchase of said practice.

3. To evaluate all information within a reasonable time period. If I decide not to pursue the proposed transaction, I will promptly advise SIMMONS & ASSOCIATES of this fact and return all proprietary information without retaining copies or extracts thereof.

4. Not to contact the veterinary practice owner, employees, suppliers, competitors, attorney, accountant, or clients except through SIMMONS & ASSOCIATES, who I hereby acknowledge to be the agency providing contact.

5. That, until permission is specifically granted by SIMMONS & ASSOCIATES, all communications between BUYER and SELLER will be handled through SIMMONS & ASSOCIATES.

6. To the understanding that, although certain information has been and will be provided which I may consider to be relevant, SIMMONS & ASSOCIATES makes no representation or warranty (implied or expressed) as to its accuracy or completeness. I agree to perform due diligence to my own satisfaction.

7. That SIMMONS & ASSOCIATES is the listing agent representing the seller, exclusively, for the purpose of selling the above-referenced practice. SIMMONS & ASSOCIATES is not providing me with any legal or tax advice regarding this potential transaction or any other practice situation.

8. SIMMONS & ASSOCIATES participates in the Simmons Education Fund (SEF), an independent non-profit educational organization. The SEF accepts voluntary contributions from various institutions, businesses, and individuals for the advancement of business knowledge of veterinary practitioners and students.

9. That SIMMONS & ASSOCIATES agrees not to reveal to anyone other than the owner and other associates of SIMMONS & ASSOCIATES, any conversations or correspondence held with the undersigned regarding this potential transaction.

AGREED TO AND ACCEPTED THIS DAY
OF MONTH ,

I agree to these terms of service.