Franchise Inquiry Form

1) Personal Details

Full Name*

Age*

Male Female Other

Mobile Number* (10 digits)

Alternate Number

Email ID*

Current Address*

City*

State*

2) Business / Background

Current Occupation / Business:
Do you own commercial property? Yes No

If Yes, Location & Area (sq.ft.):
Any previous experience in healthcare/retail? Yes No

3) Investment Details

Mini 1500 sq.ft. ₹22 Lakhs approx Standard 2500 sq.ft. ₹36 Lakhs approx Mega 5000 sq.ft. ₹61 Lakhs approx Upgrade Existing Medical Store Turn your current store into My Sehat Point

Choosing Upgrade Existing Medical Store will open store-specific fields.

4) Upgrade Existing Medical Store

Store Information

Current Store Name*

Store Address & Location*

Store Area (sq.ft.)*

Ownership: Own Ownership: Rent

Upgrade Interest

Branding & Interior Upgrade Software & CRM Access Medicine & Vendor Supply Patient, Delivery & Rider App Lab & Doctor OPD Support Marketing & Digital Promotions

Double sales in 6 months Expand customer base Add new services (lab, doctor, delivery, etc.)

5) Additional Information

Why are you interested in My Sehat Point franchise?

Immediately Within 3 months 3–6 months More than 6 months

6) Declaration

I hereby declare that all the above information is true to the best of my knowledge.

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My Sehat Point – Franchise Inquiry Form

1) Personal Details

2) Business / Background

3) Investment Details

4) Upgrade Existing Medical Store

Store Information

Business Details

Upgrade Interest

5) Additional Information

6) Declaration

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