POFOA | Proof of Financial Ability to Operate

Fixed Operating Costs

Office sublease

$

General liability insurance

$

Total Fixed Costs

$

Administrator per hour rate

$

How many hours per week

CFO per hour rate

$

How many hours per week

Medical staff per hour rate

$

How many hours per week

Medical director

$

Total Clinical Personnel:

$

Medical supplies (needles, kits, PPE, etc.)

$

EMR / scheduling software

$

Phone / internet

$

Office supplies

$

Total Operations:

$

Website and marketing

$

Estimated buffer

$

This would bring the estimated monthly operating budget to approximately:

$

For the POFA requirement, showing approximately three months of operating reserves would be:

$

Notes

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