Sale-leaseback checklist: five things to find before you say yes.

The lease term and rent escalations

• Initial lease length and any renewal options.
• Starting rent compared to similar spaces in your market.
• Exact schedule of rent increases: percent, frequency, and caps.

Your path (or lack of one) back to ownership

• Do you have a defined purchase option with clear timing and pricing, or only a right of first refusal or first offer?
• What happens to your rights if the building is sold again?
• Are the timelines and processes realistic for a busy practice?

Total cost over time vs. keeping the building

• Project total rent payments over the full likely term, including renewals.
• Compare to loan payments, taxes, insurance, and maintenance if you kept or bought the building.
• After 10–15 years: who owns the building, and what do you have to show for the payments?

Operational covenants that could box you in

• Restrictions on use, signage, or hours.
• Rules for subleasing or assigning the lease if you sell or reorganize the practice.
• Any landlord approval rights over a future buyer of your practice.

Alignment with your practice plan

• Will this lease structure still work if you grow, add providers, or change your mix of services?
• Does it make selling or transitioning the practice easier, or harder?
• Does the equity you unlock have a specific, high-value job (debt pay-down, growth investment), or is it just cash with no plan?