Franchise Inquiry Form
Personal Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Experience
Have you owned a business before?
*
Yes
No
Have you ever managed a medical or diagnostic imaging business?
*
Yes
No
If yes please explain what type
*
Are you a sonographer? *
*
Yes
No
If no, do you intend to hire a registered sonographer to operate your clinic?
*
For Sonographers Only: What ultrasound credentials have you obtained? (Check all that apply)
*
RDMS (Abdomen)
RDMS (OB/GYN)
RVT
RMSKS
ARRT-Sonography
None / In Progress
Years of clinical experience in ultrasound:
*
Less than 1 year
1–3 years
3–5 years
5+ years
Experience with 3D/4D Elective Ultrasound?
*
Yes
No
Some exposure
Are you currently working in a diagnostic or elective ultrasound setting?
*
Yes
No
If yes, please describe your current role and responsibilities:
*
Estimated Liquid Capital (Cash Available for Investment)
*
Estimated Net Worth (Assets minus Liabilities)
*
Will you require financing to start your franchise?
*
Yes
No
Maybe
If yes, have you already spoken to a lender or SBA partner?
*
Yes
No
Do you authorize us to conduct a credit check as part of the franchise application process?
*
Yes
No
Why are you interested in opening a franchise with us?
*
Are you planning to be
*
Owner-Operator (working in the business daily)
Semi-Absentee Owner (managing remotely with staff)
Passive Investor (not involved in day-to-day)
How soon are you looking to open your franchise
*
0–3 months
3–6 months
6–12 months
Are you available for a 20-minute screening call within the next 3–5 days? *
*
Yes
No
Preferred day
*
-
Month
-
Day
Year
Date
Time
*
Hour Minutes
AM
PM
AM/PM Option
Document Uploads (if applicable) • Resume / CV • Registry Certificates (RDMS, ARRT, etc.) • Letters of recommendation (if prior clinic experience)
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You've completed STEP 1!
Thank you for filling out the application.Once received, our team will carefully review your submission, including your clinical experience, financial qualifications, and overall alignment with our brand values and expectations.If your application meets the minimum requirements, we will contact you to move forward with STEP 2 of the selection process.
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