Pioneer Spine and Wellness Chiropractic

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Executive Summary

Pioneer Spine and Wellness Chiropractic is a chiropractic clinic in Utah. We help adults and families with back, neck and joint pain through gentle adjustments, therapy, exercises and clear advice about what to do between visits. Patients come after an injury, for ongoing pain or to stay active, and each visit begins with listening to what the patient wants to be able to do again.

Why this fits. Back and neck pain are among the most common reasons people look for care, and many want a hands-on option outside of pills and long waits. A clinic that explains the plan, keeps the visits short and the prices clear and refers patients to a medical doctor when that is the safer choice earns referrals from patients, doctors and physical therapists.

Here is what our numbers show. In Year 1 we plan about 2,900 adjustment visits, 800 therapy and decompression sessions, 220 new patient exams and X-rays and 600 wellness plan and supplement sales, which is about 15 patient visits a day. That brings in sales of $317,200, growing to $974,892 by Year 5 as patients and staff increase. We expect a loss of about $27,900 in Year 1 because the equipment, the lease and the team are paid before the schedule fills, then a profit of about $41,400 in Year 2, $101,700 in Year 3 and $152,200 by Year 5. Insurance companies often pay about 51 days after a visit, so the plan also holds cash for unpaid claims.

We need $225,000 in total. Of that, $118,000 is startup costs (adjusting and decompression tables, digital X-ray, furniture, software, the lease deposit, licenses, signs and insurance), and the rest is cash to cover the first months and the wait for insurance payments. I am putting in $75,000 of my own savings and asking for a $150,000 SBA 7(a) loan.

I am Nathan Pierce, the owner and chiropractor, licensed in Utah, with nine years in practice as an associate in two clinics. These numbers are estimates based on the assumptions listed at the end of this plan, not promises.

Company Description

Pioneer Spine and Wellness Chiropractic is a small, independently owned chiropractic clinic in Utah, planned as a professional limited liability company (PLLC) or whatever form our state requires for health professionals. We serve adults, teens and families in our city and the neighborhoods around it from a leased office near a main road.

Our mission. To help people move with less pain and more confidence through safe, hands-on care and honest advice.

What we believe. Every patient is different. We start with a careful history and exam, explain what we find in plain words, and offer a plan with a clear goal and end point. We do not promise cures, do not sell long prepaid plans before a patient knows whether care helps and send patients to a medical doctor or specialist when we find signs that need one. We protect patient records and follow the privacy laws that apply to health care.

What we offer:
- Adjustments. Gentle, targeted spinal and joint adjustments for back, neck and joint pain.
- Therapy and decompression. Soft tissue work, therapeutic exercise, heat, cold, electrical stimulation and spinal decompression.
- New patient exams and X-rays. A full history and exam, with digital X-rays when they are needed.
- Wellness plans and supplements. Monthly maintenance visits, posture and ergonomic advice, braces and supports.

Who we serve. Adults with back and neck pain, workers with desk and lifting injuries, people hurt in minor car accidents, athletes and families.

What we do not do. We do not treat conditions outside our scope, promise a result, pressure patients into long plans or take X-rays that are not needed. We do not diagnose medical problems we are not trained to manage.

How we are run. I am the owner and chiropractor and I see patients every day. A chiropractic assistant and a front desk and billing coordinator work with me from the start, an associate chiropractor joins in Year 2 and a practice manager in Year 3. An accountant and a health care attorney advise us.

Where things stand today. We have toured two offices and have a lease offer on one, quotes for the equipment and X-ray system, a letter of interest from a physical therapist and a family doctor who said they would refer patients and a list of about 60 neighbors who asked to be told when we open. (Replace this with where you really are.)

Problem & Opportunity

People with back and neck pain often feel stuck. They may wait weeks for a doctor's visit, be offered pills with side effects or be told to rest and come back. Some try a clinic and are handed a long prepaid package before they know whether the care helps. Others are confused by insurance rules and surprise bills.

Patients also have trouble finding a clinic that listens. Many describe feeling rushed. Some do not know whether chiropractic care is safe for them, and good providers say plainly when it is not.

For a new clinic, the hard parts are the cost of the equipment and X-ray system, the licenses and insurance credentialing, building a base of patients and waiting for insurance companies to pay, which can take about two months. A clinic with a thin schedule still pays rent and staff every month.

We want to be clear about what we know and do not know. Chiropractic care is a real, established service, and a clinic that treats patients well and keeps them informed earns referrals. We do not know how fast our schedule will fill, so our plan assumes a loss in Year 1 and cash to cover the wait for payments. We will use current local numbers on population and competing clinics in our final plan and will not overstate them.

Products & Services

Pioneer Spine and Wellness Chiropractic will give patients a careful exam, a clear plan and gentle care in a welcoming office.

How it works, step by step:
1. Call or book online. New patients can book a time online or by phone, and we send a short history form by email.
2. History and exam. We review the patient's history and goals, do an exam and decide together whether X-rays are needed.
3. Explain. We explain what we found, what we recommend and how many visits we expect, in plain words, with a written price.
4. Treat. We provide adjustments, therapy and exercises, and teach the patient what to do at home and at work.
5. Check progress. At set points, we measure progress against the patient's goal and adjust the plan or refer to a doctor.
6. Billing. We verify insurance before the first visit, explain what the patient owes, bill the insurer and keep clear records.
7. Wellness. Patients who feel better can choose a monthly maintenance visit, with no pressure.
8. Feedback. We ask for feedback after the first visit and again at discharge, and use it to improve.

Why this approach is strong. Patients trust a clinic that listens, is honest about what care can do and refers out when needed. Trust brings referrals from patients, doctors and therapists.

Market Analysis

Who we serve: adults, teens and families in our city and the neighborhoods around it, including workers, athletes and people with minor injuries.

Our primary group is adults aged 25 to 65 with back, neck or joint pain who want hands-on care. Our secondary group is families, active older adults and athletes. We will use the most recent local numbers on population, workers and competing clinics in our final plan.

How we sized our plan. We plan about 2,900 adjustment visits, 800 therapy sessions, 220 new patient exams and 600 wellness sales in Year 1, about 15 patient visits a day, growing to 7,500, 2,400, 580 and 1,900 by Year 5, about 40 visits a day with two chiropractors. Our Year 1 prices are about $62 per adjustment visit, $88 per therapy session, $190 per exam with X-rays and $42 per wellness sale, rising about 3% a year. Prices are an average across self-pay and insurance payments.

Demand data. A letter of interest from a physical therapist and a family doctor and a list of about 60 neighbors cover part of the first months. We do not count on any one source. Patients often come in waves after a season of yard work, snow shoveling or a sports season.

We do not take every patient. We decline care when a patient needs a medical doctor first, and we do not accept cases that fall outside our scope.

Competitive Landscape

Other choices for patients, and what makes us different.

- Large chiropractic chains. They advertise heavily and often sell prepaid plans. We offer a doctor who knows the patient and no long prepaid packages.
- Other independent chiropractors. Some are excellent. We compete on listening, clear plans and short wait times.
- Physical therapy clinics. They are a good choice for some injuries, and we plan to work with them. We offer fast access without a referral.
- Primary care doctors and urgent care. They can rule out serious causes. We offer longer visits and hands-on care once serious causes are ruled out.
- Massage and wellness studios. They offer relaxation. We offer exam, diagnosis within our scope and a treatment plan.

What makes us different.
- A careful exam and a written plan with a goal and an end point.
- No pressure and no long prepaid packages.
- Referrals to doctors and therapists when they are the safer choice.
- Fast appointments and a clean, welcoming office.

What we do not claim. We are new. Larger clinics have more locations and bigger budgets. We plan to earn trust one patient at a time.

Marketing & Sales Strategy

How we will reach customers.

Doctors, therapists and gyms. We will meet family doctors, urgent care clinics, physical therapists, personal trainers and gym owners, give them a one-page guide to when we refer and offer to see their patients quickly.

Employers and community events. We will offer a short ergonomics talk to nearby employers and offer a screening table at 5K runs, health fairs and school sports nights.

Online. A website with online booking and a plain description of our care, a Google business listing, a review program and a small budget for local search ads.

Patient referrals. Every patient is asked to refer a friend, and each new patient who comes by referral gets a thank-you and a discount on their first visit.

Pricing. About $62 per adjustment visit, $88 per therapy session, $190 per exam with X-rays and $42 per wellness sale in Year 1, with a written price list and a clear insurance policy.

Operations Plan

How the business will run.

Setup (the 4 to 6 months before opening). We will form the entity, get an EIN and open a business bank account, confirm the license, X-ray registration and billing credentials our state and insurers require, sign the lease, install the tables and X-ray system, set up the billing software and hire and train staff. Insurance credentialing can take months, so we will start early and plan to see self-pay patients first.

The office. A leased office of about 1,800 to 2,200 square feet with a reception area, three treatment rooms and an X-ray room. Rent is $48,000 a year in Year 1.

Staffing. In Year 1: I serve as owner and chiropractor. A chiropractic assistant, paid $35,000 a year, and a front desk and billing coordinator, paid $34,000 a year, work with me. An associate chiropractor, paid $80,000 a year, joins in Year 2 and a practice manager, paid $48,000 a year, joins in Year 3. The team grows to two associates in Year 4 and three assistants.

Costs. Direct costs are small: about $6 per adjustment visit, $11 per therapy session, $22 per exam with X-rays and $19 per wellness sale in Year 1. Rent is $48,000 a year, utilities and phone about $4,800, malpractice and liability insurance about $6,500, a billing service and software about $9,600 and marketing about $18,000.

Privacy and safety. We follow the privacy and records laws that apply to health care, keep records secure, use consent forms and screen for conditions that need a medical doctor.

Payments. About half of our patients will pay through insurance, which often pays about 51 days after a visit. The rest pay by card at the visit. Our plan holds about $44,408 in unpaid claims at the end of Year 1.

Insurance. We carry malpractice, general liability, property and workers' compensation coverage.

Management & Organization

The people who will run Pioneer Spine and Wellness Chiropractic.

Nathan Pierce, owner and chiropractor. Licensed in Utah, with nine years in practice as an associate in two clinics, where he treated patients, led a small team and learned insurance billing. He leads care, staffing, sales and finance. (Replace this paragraph with your own license, education and background.)

Chiropractic assistant (from Year 1). Prepares patients, teaches exercises and supports the doctor in each room.

Front desk and billing coordinator (from Year 1). Books visits, verifies insurance and manages claims.

Associate chiropractor (from Year 2). Treats patients and builds the schedule.

Practice manager (from Year 3). Runs scheduling, billing and compliance.

Outside advisors. A health care attorney, an accountant, an insurance broker, a family doctor and a free mentor from SCORE or the Small Business Development Center.

Staff pay in this plan is a full year per person: owner and chiropractor $80,000, chiropractic assistant $35,000, front desk and billing $34,000, associate chiropractor $80,000 and practice manager $48,000. Replace them with the pay you can offer where you live.

Milestones Narrative

Our goals and when we plan to reach them.
- Before opening (4 to 6 months ahead): sign the lease, confirm the license, X-ray and billing requirements, install the tables and X-ray system, set up billing software, hire and train staff, start insurance credentialing and book at least 40 first-month appointments through neighbors and referrals.
- Year 1: about 15 patient visits a day, an assistant and a front desk and billing coordinator; $317,200 in sales and a loss of about $27,900.
- Year 2: about 25 visits a day, an associate chiropractor and a second assistant; $551,050 in sales and a profit of about $41,400.
- Year 3: about 33 visits a day, a practice manager and a second front desk person; $744,358 in sales and a profit of about $101,700.
- Year 4: about 37 visits a day, a second associate chiropractor and a third assistant; $875,930 in sales and a profit of about $92,700.
- Year 5: about 40 visits a day with two chiropractors and a full team; $974,892 in sales and a profit of about $152,200.
Growth depends on winning and keeping customers, so treat the later years as goals, not promises.

What we check every week: new patients, patient visits, no-shows, insurance claims sent and unpaid, average collection per visit, patient reviews and cash in the bank.

Funding Request

How much we need and how we will use it. Total we are raising: $225,000.

How we got that number. The Funding Need Calculator in this plan adds up three things:
- Startup costs of $118,000, listed item by item in the Startup Costs section: $32,000 for adjusting tables, a decompression table and therapy equipment; $36,000 for digital X-ray system and viewing software; $11,000 for reception furniture, exam room fixtures and waiting area; $7,000 for computers, practice management and billing software setup; $8,200 for lease deposit and first month of rent; $3,400 for business license, X-ray registration and billing credentialing with insurers; $5,000 for attorney and accountant: lease review, professional LLC, books; $7,000 for sign, brochures, branding and website; $3,200 for opening supplies: linens, table paper, braces, supplements; $5,200 for malpractice and liability insurance down payment.
- The cash the business uses before it breaks even, about $37,200. Insurance companies often pay about 51 days after a visit and the schedule takes months to fill, so cash is needed to cover pay and rent until payments catch up.
- A cash cushion of about $66,700: three months of Year 1 operating costs.
- Together, the cash used before break even and the cushion come to about $103,900, and the three pieces add up to about $221,850, rounded up to the nearest $500: $222,000.
We are raising $3,000 more than that, $225,000 in all, to cover the extra weeks insurance credentialing can take and the cost of the associate and second assistant in Year 2. With this funding, the lowest year-end cash balance is about $76,400, at the end of Year 1.

Where the money comes from:
- My own money: $75,000.
- SBA 7(a) loan: $150,000.

Kind of funding we are looking for. An SBA 7(a) loan from a lender that finances health care practices, backed by my own savings and the equipment as collateral.

How we will pay it back. We expect a loss of about $27,900 in Year 1, a profit of about $41,400 in Year 2, a profit of about $101,700 in Year 3, a profit of about $92,700 in Year 4 and a profit of about $152,200 in Year 5. With this funding, the business has money in the bank at the end of every year of the plan. Our loan is the SBA 7(a) loan at 12.5% over 10 years, about $2,196 a month. That payment is already included in our cash flow. We chose these as cautious planning rates; ask the lender for the real rates, which may be lower or higher.

What we are offering the lender: the equipment and my personal guarantee.

A smaller first step, if needed. If we cannot raise the full amount right away, we can start smaller and grow into this plan:
- Phase 1: open with a smaller office, one treatment room fewer, a rented X-ray arrangement and one assistant, which lowers startup costs and the loan.
- Phase 2: once the schedule fills, add the X-ray system, an associate and more staff and follow this plan.
To plan the smaller start, make a copy of this plan (use Duplicate) and lower the numbers to match.

All numbers in this plan are estimates. We will update them as real results come in.

Appendix Notes

Documents to attach before you send this plan:

- Your resume, license, malpractice insurance quote and a personal financial statement (a list of what you own and what you owe; lenders usually provide a form).
- Business registration papers and your EIN (your business tax number from the IRS, free at irs.gov).
- The lease or a letter of intent from the landlord.
- Quotes for the tables, X-ray system and billing software.
- Your X-ray registration and insurer credentialing applications.
- Your consent forms, privacy policy and written price list.
- Letters of interest from doctors, therapists and gyms.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Adjustment Visits (per visit): about $62 in Year 1, rising to $69.78; about $6 in direct costs, rising to $6.75; about 2,900 in Year 1, growing to 7,500.
- Therapy and Decompression Sessions (per session): about $88 in Year 1, rising to $99.04; about $11 in direct costs, rising to $12.38; about 800 in Year 1, growing to 2,400.
- New Patient Exams and X-Rays (per exam): about $190 in Year 1, rising to $214; about $22 in direct costs, rising to $24.76; about 220 in Year 1, growing to 580.
- Wellness Plans and Supplements (per sale): about $42 in Year 1, rising to $47.27; about $19 in direct costs, rising to $21.38; about 600 in Year 1, growing to 1,900.
- About 2,900 adjustment visits in Year 1 is roughly 11 a day on 260 working days; with therapy, exams and wellness sales, about 15 patient visits a day. Prices are an average across self-pay and insurance payments and rise about 3% a year.
- Equipment ($86,000 in Year 1) covers the tables and the X-ray system, and later years replace tables and software and add small items.
- Pay (a full year, per person): owner and chiropractor $80,000; chiropractic assistant $35,000; front desk and billing $34,000; associate chiropractor $80,000; practice manager $48,000.
- Other yearly costs in Year 1: rent $48,000, utilities and phone $4,800, malpractice and liability insurance $6,500, insurance billing service and software $9,600, marketing and community events $18,000, accounting and legal $4,800, payroll taxes and benefits $26,000. These grow between 3% and 12% a year.
- Startup equipment and later purchases ($86,000 in Year 1, then $5,000, $5,000, $6,000 and $6,000) are spread evenly over five years in the plan's books.
- Customers and payers pay about 51 days after service, so at the end of Year 1 about $44,408 is still owed to us. Income tax at 21%.
- Every dollar amount is an estimate. Replace them with your own quotes and research.

Startup Costs