Partnership Prequalification Application

Thank you for your interest in owning your own DexaFit!
Please take the next few minutes to submit our brief questionnaire and introduce yourself before our call.

Erin will then be in touch shortly after to check your availability.
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Prefix *

First Name *

Last Name *

Date of Birth *


City/Town *

State/Province *

Country *

Phone number *

Have you ever been convicted of a felony? *

Please explain the nature of your felony.

Have you been tested at one of our facilities? Please select which tests you have completed. *


Highest level of education completed *

Degree/Certificates earned *

Please describe your current position and responsibilities *

Have you ever owned/operated your own business? If so, please describe. *

Please describe any special skills or experience that differentiates you from other applicants? *

At DexaFit, board members, administration, and location owners work closely together to continuously create, maintain, and expand our best business practices. What unique skills and experiences will you bring to the DexaFit team?
Please provide a link to your LinkedIn page if you have one.


Upon request, are you willing to provide proof of income? *

Will you require outside financing? *

Sources of Income *

Gross Annual Income *

Amount of cash available for investment *

Have you ever filed for bankruptcy? *

Date of Bankruptcy


Upon request, are you willing to provide documentation regarding personal assets? *

Home Ownership *


Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff? *

Do you intend to use DexaFit as a means to promote other products or services? If yes, please explain in detail here: *

Following Up

What would be your timeline to invest in your location and get started? *

Are you interested in visiting DexaFit for an administrative site tour?

Area of interest?

To open your DexaFit location(s).
How did you hear about DexaFit and what is your main interest in opening a location? *

Do you have any immediate questions?

Are you willing to submit to a background check?

***Applicant responsible for processing fee. No payment due at this time. *

Thank you for your time! We will review your answers soon then be in touch to schedule a call.

Please also note (and forgive us), if you experience a delay of up to 3 days before your form is reviewed. Maybe 4.
thanks again >
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