DRL Diligence Intake Form

Section 1

Who are you?

Organization Name First Name Last Name Title Email Phone

Section 2

Which best describes you?

Operator (SNF owner, administrator, multi-site) Lender / Credit Team Investor / Family Office Healthcare REIT Private Equity Consultant / Advisor Other

Section 3

What are you evaluating?

Acquisition Due Diligence Portfolio Risk Review Refinancing Receivership / Turnaround Internal Compliance Review Federal Audit Defense Revenue Integrity Assessment Expert Witness / Litigation Support

Section 4

Portfolio details

Facility Name CCN (optional) State Licensed Beds Current Occupancy % Ownership Structure

Section 5

What’s keeping you up at night?

Section 6

Deal intelligence

Estimated Enterprise Value Timeline Portfolio Size

Section 7

Upload documents

Preferred uploads: MDS export, census report, UB-04 sample, therapy utilization, financial statements, CMS CASPER reports. Storage can connect to Supabase when configured; filenames are captured with this intake today.

Drag & drop files here

PDF, Excel, CSV · Up to 50MB each

Section 8

Confidentiality acknowledgement

I understand DRL Holdings provides decision-support analysis only and does not assign diagnosis codes or bill Medicare. I authorize DRL Holdings to review submitted documents solely for diligence purposes. I would like to receive my preliminary Healthcare Value Intelligence report.

Submit

Request Confidential Diligence Review

What happens next? Within 48 hours, you’ll receive:

Executive Risk Summary
Revenue Opportunity Score
Compliance Exposure Rating
Recommended DRL Intelligence Package

Protected under HIPAA-ready workflows. NDA available upon request.