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Letter of Instructions / Disability ProgramLetter of Instructions / Disability Program

Thank you for your interest in our Letter of Instructions / death and disability program. Your steps now are the key to set your practice up for success in event of the unexpected happening to you. Upon receiving your request, you will be contacted by one of our specialists with documentation and to discuss setting up a consultation.

If you have any questions prior to our contacting you, please feel free to contact us at 800.262.4119 or email us.

Note: All information on this form is REQUIRED.  All information will only be used by Henry Schein Professional Practice Transitions, and not released to any third party.

Would you like more information or do you have a question?

Complete the following and one of our local experts will be in touch soon.

  Your Name:

  Year you Started Practicing:
  Sq. Footage of your Office:
  Number of Operatories:
  City and State:
  Preferred Phone Number:
  Preferred Email Address:
  How you found
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