The veterinary practice startup checklist, 18 months to opening day

Why the order matters

Most startup checklists are alphabetical piles: licences, loans, marketing, staffing. The trouble is that the pile hides the dependencies, and the dependencies are what make first-time owners late. A lender will not close without a signed lease or a letter of intent. The DEA registers a practitioner at a specific address, so nothing federal can be filed until the address exists.[2] Contractors cannot pull permits without stamped drawings. Staff cannot be hired without an opening date. Work backwards from the day you want the doors open and each task finds its slot.

The phases below mirror our opening timeline, which starts 18 months out by default. A second-generation medical space with financing in hand can compress the front end; a ground-up build usually cannot.

18 to 12 months out: decide and finance

Everything here is paper, and it is the paper that decides whether the rest happens on schedule. The projection is the document a lender reads first, and the service mix is what sets the floor plan.

• Write the business plan and a three-year projection. Use a sourced funding number rather than a guess; our startup cost calculator was built for this page of the plan.
• Talk to two veterinary practice lenders. SBA 7(a) loans run up to $5 million and can fund the build-out, equipment and working capital.[8] Start-ups must put in at least 10 percent of total project costs as equity.[9] Practice lenders commonly offer up to six months interest-only while the clinic ramps.[10] Get pre-qualified before you fall in love with a building.
• Decide the model and the services. General practice, urgent care or mixed; dentistry, surgery, imaging, boarding. Every choice adds or removes rooms, plumbing and equipment.
• Pick the market and shortlist three sites. Drive time, visibility, parking, competing clinics, and whether the space can physically take a surgery suite and radiography.
• Engage a veterinary architect or design-build firm. Ask for veterinary references. Animal facilities have their own plumbing, ventilation and noise problems, and a general contractor learning on your job learns with your money.

12 to 9 months out: the building and the loan

This is where the lease, the loan and the entity lock together. The letter of intent unlocks the loan application; the loan approval unlocks the lease signature; the entity has to exist before either can be signed in its name.

• Letter of intent on the space. Negotiate the build-out period and a tenant improvement allowance now, before the lease is drafted.
• Form the entity, get the EIN, open the accounts. The EIN is free, issued immediately online, and limited to one per responsible party per day.[7] Then the bank account, the credit card and the payroll provider.
• Submit the loan application. Plan, projections, letter of intent and personal financial statements. Ask the lender for their closing timeline in writing and plan the lease around it.
• Sign the lease. Rent should start after the build-out period, not at signature.
• Zoning, building and sign permits. Timelines depend entirely on the jurisdiction; start the moment the drawings are stamped.

9 to 6 months out: build, order, register

Construction begins and the registrations begin. The registrations feel early. They are not: several are sequential, most involve an agency you do not control, and one of them cannot be filed until the lease exists.

• Freeze the design and the equipment list. Changes after this point cost money and weeks.
• Order long-lead equipment. Radiography, the dental unit and dental x-ray, surgery table, anesthesia machines, cages and runs.
• Construction starts. Weekly site walk. Photograph everything behind the walls before they close.
• State veterinary licence at the new address. Then the state premises or facility permit where your board requires one. North Carolina requires a veterinary facility permit for any business operating a facility that practises veterinary medicine;[11] California registers every veterinary premises and inspects it.[12]
• State controlled-substance registration, then DEA Form 224. The DEA registers practitioners per location, at $888 for three years.[1][2] Applications are filed online.[5] Where the state requires its own registration, it generally comes first, so file it the week the lease is signed.
• Register the x-ray machines. Radiography and dental x-ray are registered with your state's radiation control program; the CRCPD keeps the directory of those programs.[16]
• USDA accreditation for at least one veterinarian. Health certificates for travel need an accredited veterinarian. The path is initial accreditation training online, an orientation program, then VS Form 1-36A to your state NVAP coordinator with proof of degree and licence; the application must be filed within three years of the orientation, and no accreditation work may be done until written approval arrives.[6]
• Insurance in place. General liability, property, professional liability, business interruption, and workers' compensation once you have employees. Lenders will ask for the certificates.

6 to 3 months out: systems and people

The building is a construction site and the business starts to exist. The people you hire now build the schedule, the inventory and the culture with you, and the systems you sign now need this long to be ready.

• Sign the practice software and set the opening date. Catalog, fee schedule and templates take weeks to build well. On Bittsi's New Practice Program billing starts on opening day, not at signature.
• Hire the practice manager or lead technician. Six months out, so they own the setup rather than inherit it.
• Open lab and distributor accounts. Reference lab, distributor, compounding pharmacy, crematorium.
• Finalise the fee schedule and service catalog. Priced from your costs and your market, loaded into the software once.
• Website, Google Business Profile and social channels live. Google chooses the verification method; review can take up to five business days, and most postcards arrive within 14 days.[15] A coming-soon page with pre-booking beats a launch-day website.
• Hire technicians and front desk. Offers now, start dates three to six weeks before opening.
• Payment processing and the terminal. Settled before training so the front desk rehearses on the real thing.

The last 90 days

Ninety days is where the checklist turns physical: the safe, the shelves, the staff and the inspectors. It is also where the compliance items with hard triggers live.

• Controlled-substance cabinet, logs and protocols. Practitioners must store controlled substances in a securely locked, substantially constructed cabinet.[3] Take the initial inventory on the day you first dispense, and a new one at least every two years.[4] Set all of it up before the first order arrives, not after.
• Place the opening inventory order. Staged deliveries: pharmacy and consumables two weeks out, perishables the week of.
• Equipment installed and calibrated. Radiography acceptance testing, dental unit, autoclave validation.
• Staff accounts, permissions and the training plan. Every role set up before the first shift.
• Workplace posters and records. Employers must display OSHA's Job Safety and Health poster, which is free; never pay a vendor for it.[13] With 10 or fewer employees at all times during the last calendar year you are exempt from the injury and illness log unless told otherwise in writing, though severe incidents must still be reported.[14]
• Team starts; training week one. Live sessions on the software, the protocols and the phones. Record them for later hires.
• Inventory delivered and shelved. Counted into the system, with minimums and reorder points set.
• Pre-booking opens; reminders live. Neighbourhood mailer, local groomers and shelters, a community open house.
• Dry run. Two mock days with staff pets, chart to invoice, with the emergency and controlled-substance protocols rehearsed.
• Final inspections and the certificate of occupancy. Fire, health, building, and the board's premises inspection where required. Keep copies at the front desk.
• Soft opening. Friends, family and staff pets. Fix what breaks.

Opening day and the first quarter

The checklist does not end at the ribbon. The habits that keep a young clinic alive are set in the first twelve weeks, when every number is small enough to understand.

• Opening day. The software subscription starts today. Nothing else changes.
• Weekly numbers review from week two. New clients, visits, average transaction, no-shows, cash in the bank.
• Ninety-day review. Hours, hiring, the fee schedule, marketing spend, and what the first 300 clients told you.
• Calendar the recurring compliance. The biennial controlled-substance inventory,[4] DEA renewal every three years,[1] premises permit and licence renewals on the board's cycle.

Where the order goes wrong

• Signing the lease before the loan is approved. Rent starts on a building the bank has not yet agreed to fund.
• Leaving the DEA application for the build phase. It cannot be filed before the address exists and it is not fast; file the week the lease is signed.[2]
• Hiring the team before the date is firm. Payroll starts and the opening slips.
• Treating the premises permit as a formality. Where the board inspects, the inspection is on their calendar, not yours.[12]
• Buying software late. The catalog and the training need the months; the invoice does not have to.
• No one accredited on opening day. The first travel certificate request arrives in the first month.[6]