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Why Accessible
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Franchise Application

Franchise Application Form

We are delighted that you are considering Accessible Home Health Care to start your own home health care business. This is a non-binding application that can be withdrawn at any time, no fees required. After we receive your application, we will send your Franchise Disclosure Document (FDD) shortly.

Name

Please fill out the form below.

Title

First Name

Last Name

Home Address

State

Zip

Cell Phone

Home Phone

Business Phone

Fax Number

Best phone to contact.

Best time to contact

Email Address

Employer

Job Title

Number of Dependents

Spouse’s Name

Marital Status

Spouse's Employer and Job Title

Will anyone other than your spouse be involved in the ownership and operation of the business with you? *

Yes No

If ‘YES’, please list the name(s) below and have the other applicant(s) fill out a separate application.

Do you have previous experience working in home health care? *

Yes No

If ‘YES’, please provide details about your experience.

Have you ever filed for bankruptcy? *

Yes No

If ‘YES,’ please provide bankruptcy details.

Have you been convicted of a crime in the last 10 years? *

Yes No

If ‘YES,’ please provide details of conviction.

When are you looking to open your business?

Where would you like to locate your business?

You need $125,000.00 (initial franchise fee included) to open this franchise. Are you able to invest this amount? *

Yes No

Do you have sufficient funds to support yourself and dependants for at least 6 months during your business development phase? *

Yes No

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What It Takes
Why Accessible
Lucrative Territories
Steps to Ownership
FAQs
Financing & Investment
Veterans
Franchise Guide
Franchise Application
Contact Us