Before You Sign the Lease: The Five Questions We Wish We’d Asked

Of all the early decisions, the lease is the one that follows you the longest. You can re-price a service, re-do a logo, even re-hire a front desk — but a five-year lease is five years.

Before you sign anything, sit with these five questions. None of them are clinical. All of them have ended practices that had nothing wrong with the medicine.

The order matters more than the items

Most clinicians open with the space because the space feels like proof — somewhere real to point to. But a lease commits cash and time before you have either the patients or the systems to absorb it. The room can wait. Almost everything that earns can be built before you hold a key.

A lease almost never belongs first. It belongs after demand, after pricing, after the model is proven on paper.

The five questions, briefly

• What is the true all-in monthly cost — base rent, CAM, build-out amortized, and the months you’ll pay before you open?
• How many patients per week does this room require just to break even, and is that number realistic in this location?
• What are the exit terms — assignment, sublet, and personal guarantee — if the medicine is fine but the math isn’t?
• Does the zoning and the landlord actually permit a medical aesthetic use, in writing?
• If you walked away from this exact space today, what would you lose — and is that loss survivable?

None of these are about the medicine. All of them have ended practices that had nothing wrong with the medicine. Get the order right, and the lease becomes a decision you make from strength — not one that makes you.

Ready to build the practice, not just read about it?

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