www.newuwomensclinic.com - Franchise Inquiry Application

Franchise Inquiry Application

Confidential – For Evaluation Purposes Only
Thank you for your interest in owning a New U Women’s Clinic & Aesthetics franchise.

This application will help us learn more about your background, financial qualifications, and vision so we can determine if we’re the right fit for one another.
Section 1 – Personal Information
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Preferred Method of Contact*

PhoneEmail
Are you a U.S. Citizen or Permanent Resident?*

YesNo
Marital Status

SingleMarriedOther
Section 2 – Business & Professional Background
Current Occupation/Title
Employer/Business Name
Years in Current Role
Have you owned a business before?*

YesNo
If yes, please describe*
Do you have experience in healthcare, wellness, or aesthetics?*

YesNo
If yes, please elaborate*
Have you ever been involved in franchising?*

YesNo
Section 3 – Investment & Financial Information

Please note: This information is confidential and used only to assess your financial readiness for franchise ownership.
Approximate Net Worth
$
Liquid Assets Available for Investment
$
Source(s) of Capital

Personal SavingsInvestor(s)Loan/FinancingOther
Have you ever filed for bankruptcy?*

YesNo
Do you have any current liens or legal judgments?*

YesNo
Section 4 – Territory & Operational Plans
Preferred City/State for Your Franchise Location
Are you willing to consider other available territories?*

YesNo
How soon are you looking to open your franchise?

Immediately3–6 Months6–12 Months12+ Months
Do you plan to operate the business yourself?*

YesNo
If no, who will manage day-to-day operations?
Section 5 – Motivation & Vision
Why are you interested in owning a New U Women’s Clinic & Aesthetics franchise?
What strengths and skills will you bring to your clinic?
What are your long-term business goals?
Section 6 – Acknowledgement & Signature
By signing below, I affirm that the information provided in this application is true and complete to the best of my knowledge. I understand that this is an initial inquiry and does not constitute an offer to sell or a commitment to purchase a franchise.
Would you like to receive SMS messages from our franchising team.*

Yes - I want to receive SMS messages.No – I would like to opt-out of receiving SMS messages
Signature*
Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

Franchise Inquiry Application

Thank you for your interest in owning a New U Women’s Clinic & Aesthetics franchise.

Section 1 – Personal Information

Section 2 – Business & Professional Background

Section 3 – Investment & Financial Information

Section 4 – Territory & Operational Plans

Section 5 – Motivation & Vision

Section 6 – Acknowledgement & Signature