Free Checklist

12 Red Flags in a DSO Offer

A dentist-to-dentist checklist for practice owners reviewing a term sheet, APA, earnout, or rollover structure.

By Blane Jackson, DDS/MBA · Practicing dentist and multi-practice owner/operator · Updated April 2026

The first DSO offer usually looks cleaner than it is. This checklist isolates the 12 clauses and deal mechanics that most often change the real economics, your post-close control, or your future ability to practice where you want.

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Download the PDF below. If you already have an offer in hand, the fastest paid next step is the $497 Express Scorecard.

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Next step: get the Express DSO Offer Scorecard. For $497, send the offer basics through Stripe checkout and get a concise 48-hour screen before you decide whether a full review is warranted.

What is inside

Flag 01Multiple below current market range
Flag 02Aggressive doctor-comp normalization
Flag 03Cash at close below 70%
Flag 04Earnout longer than 24 months or above 30%
Flag 05Employment term locks you in for 5+ years
Flag 06Unreasonably broad non-compete
Flag 07Real estate bundled into the practice deal
Flag 08Illiquid or non-voting rollover equity
Flag 09Clinical autonomy treated as advisory
Flag 10Associate doctors lose protection
Flag 11Uncapped reps, warranties, or indemnity
Flag 12Pressure for an artificially quick close

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No phone number. No broker handoff. Just the checklist and follow-up material for dentists evaluating real offers.

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Fastest paid next step

If you already have an offer in hand

The lowest-friction paid path is the $497 Express Scorecard: enter the offer basics, pay through Stripe, then send the LOI or offer PDF for a concise 48-hour screen.

Start the paid Express Scorecard Compare review tiers How to read a DSO offer

Educational only. This site reflects general industry information and the author's personal experience as a practicing dentist and multi-practice owner/operator. It is not legal, tax, or financial advice. Every transaction is unique — engage a CPA, attorney, and qualified advisor familiar with your jurisdiction before acting on any guidance here. We have no DSO, broker, or buyer-side fee unless explicitly disclosed on the relevant page.