⚠️ REQUIREMENTS TO APPLY TO BE A PUBLIC EESYSTEM CENTER ^*

1️⃣ MUST ORDER A 12-UNIT OR GREATER EESYSTEM

2️⃣ COMMERCIAL SPACES ARE PRIORITIZED.

*We may consider home-based centers on a case-by-case basis.

3️⃣ CENTER MUST BE WHEELCHAIR ACCESSIBLE.

4️⃣ HAVE FUNDING IN PLACE TO ORDER YOUR EESYSTEM WITHIN THE NEXT MONTH.

Do you understand and agree to these requirements?

Yes

No

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⚠️ WHAT IS NEEDED IN THIS APPLICATION ^*

📍 HAVE 1-3 DESIRED LOCATIONS FOR YOUR PUBLIC CENTER.

👥 FULL LEGAL NAMES AND EMAILS OF 1-4 SIGNATORIES ASSOCIATED WITH YOUR CENTER.

🏡IF AN IN-HOME CENTER, you will be asked to submit pictures and a video tour of your layout for review.

Do you have these ready to proceed?

Yes

No

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SECTION 1

🖥️ EESYSTEM INFORMATION

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EESystem Size ^*

What size of EESystem would you like to order?

12-unit

16-unit

20-unit

24-unit

32-unit

36-unit

40-unit

48-unit

72-unit

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Interest in purchasing a used EESystem ^*

Not only will you receive your EESystem much sooner than ordering new, you may save by going with a used system purchase. We can't guarantee one will be available, but if you're interested, we will do find a used system for you.

Yes

No

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Are you interested in joining UNIFYD Healing?

This is not required to proceed, however, we highly encourage partnering with a marketing agency (like UNIFYD Healing) to enhance awareness of your center in the community. By selecting "No", you are welcome to explore other local options to support your marketing efforts.

Yes

No

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SECTION 2

🏥 CENTER INFORMATION

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Country where you plan to open center: ^*

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LOCATION 1: Most Desired / Current Center Location: ^*

🗺️ Please be as specific as possible.

Simply providing a city/town may result in your application being declined. If you don't have an exact address, providing a suburb or neighborhood greatly helps us in our review.

Include street, city, region, country

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LOCATION 2: Second Desired Center Location:

[Optional]

🗺️ Please be as specific as possible.

Simply providing a city/town may result in your application being declined. If you don't have an exact address, providing a suburb or neighborhood greatly helps us in our review.

Include street, city, region, country

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LOCATION 3: Second Desired Center Location:

[Optional]

🗺️ Please be as specific as possible.

Simply providing a city/town may result in your application being declined. If you don't have an exact address, providing a suburb or neighborhood greatly helps us in our review.

Include street, city, region, country

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Where do you plan to operate your center? ^*

Commercial

In-Home

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In-Home Review ^*

Since you are planning to open your center in-home, we require photos and videos of your space to review to ensure it meets our quality assurance.

📸 PHOTOS: Take photos of your space, including the yard as viewed from the public, your entrance, and the space where the EESystem would be installed.

🎥 VIDEO TOUR: Additionally, a recorded video entering your home and walking to the space where the EESystem would be is appreciated and will assist our team in review.

You can drag & drop or paste as well

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Center Name:

⚠️ If you do not have a center name yet, you can leave this blank. Alternatively, this could be the company name you want to sign as.

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SECTION 3

👥 ABOUT YOU & YOUR BUSINESS PARTNERS

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Do you have any experience as a business owner? ^*

Yes

No

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Have you worked in holistic wellness? ^*

Yes

No

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Why do you want to open a public center? ^*

/

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Why do you feel you would be a good fit to operate a center? ^*

/

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How many signatories will be signing? ^*

⚠️ Our agreement contains spaces for 1-4 signatories/partners.

1 (Just Me)

2

3

4

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SIGNATORY 1: Your First & Last Name ^*

⚠️ This must be your legal name. No nicknames.

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SIGNATORY 1: Your Email ^*

✉️ This email address will be the primary contact email on your file. It can be updated later.

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SIGNATORY 1: Phone Number ^*

📞 This phone number will be the primary phone number on your file. It can be updated later.

By providing your phone number, you agree to receive communications by text message about your inquiry. You may opt out by replying STOP or ask for more information by replying HELP. Message frequency varies. Message and data rates may apply. You may review our Privacy Policy to learn how your data is used.

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SIGNATORY 2: First & Last Name ^*

⚠️ This must be a legal name. No nicknames.

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SIGNATORY 2: Email ^*

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SIGNATORY 3: First & Last Name ^*

⚠️ This must be a legal name. No nicknames.

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SIGNATORY 3: Email ^*

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SIGNATORY 4: First & Last Name ^*

⚠️ This must be a legal name. No nicknames.

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SIGNATORY 4: Email ^*

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Hereby Known As: ^*

For our agreement, we require a "Hereby Known As". Please provide what you would like this to be.

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SECTION 4

📋 CLOSING DETAILS REGARDING THIS APPLICATION

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⏰ TIMEFRAMES AND DEADLINES

Due to the number of applications we receive in similar areas, we ask that you complete your order in under 2 months (preferably 1 month or less).

This ensures a smooth and efficient order process with minimal delays for others who may be interested.

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📊 BUSINESS & FINANCIAL ADVICE

We do not provide business or financial advice.

If you have questions about how to operate a business or need financial assistance, we will be unable to assist with these topics. We are dedicated and determined to assist each and every one of you in a timely manner.

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📩 WATCH YOUR JUNK FOLDER

📩 Please watch your junk folder as some applicants report not receiving our responses via email as they go to their junk folders.

We normally reply within 2-3 weeks (or less).

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YOU DID IT! 🎉

Thank you for completing this application in its entirety!

We understand it is quite lengthy but appreciate your time and commitment to complete it.

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✅ YOUR APPLICATION HAS BEEN SUBMITTED!

You should receive an auto-email reply confirming receipt of your application. Be sure to watch your junk folder.

We will be in contact with you as soon as we can!

❌ YOU SELECTED AN OPTION TO END YOUR APPLICATION.

Please return when you are ready to proceed with the application!

We look forward to hearing from you soon.

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WELCOME TO THE PUBLIC CENTER APPLICATION

SECTION 1

SECTION 2

SECTION 3

SECTION 4

⏰ TIMEFRAMES AND DEADLINES

📊 BUSINESS & FINANCIAL ADVICE

📩 WATCH YOUR JUNK FOLDER

YOU DID IT! 🎉

✅ YOUR APPLICATION HAS BEEN SUBMITTED!

❌ YOU SELECTED AN OPTION TO END YOUR APPLICATION.