In what form can the Healthsource Chiropractic Acknowledgement be executed?
Healthsource_Chiropractic Franchise · 2025 FDDAnswer from 2025 FDD Document
lletin: Practices of Business Consultants. We | | HSC is not engaged in rendering legal, accounting, | or other professional services or advice. | | your patients, taxes, employees, | If you require legal advice or other expert assistance, the services of a competent professional person should | | or disputes. | be sought. HSC is not a law firm. We do not practice law and cannot provide you with legal advice about | | Agreed and accepted by: | | | | | | Signature of Franchisee | Date | | | | | Printed Name | | | Acknowledged and agreed by: | |--------------------------------| | HealthSource Chiropractic, LLC | | | | By: | | Its: |
EXHIBIT K
Franchise Deposit Acknowledgment and Amendment
HEALTHSOURCE CHIROPRACTIC, LLC FRANCHISE DEPOSIT ACKNOWLEDGEMENT
TO HEALTHSOURCE CHIROPRACTIC, LLC:
| 1. Introduction. I understand that my application for the grant of a franchise to operate a HealthSource |
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| Chiropractic, LLC |
| ("HealthSource") clinic in the area set forth on the attached map (the "Protected |
| Territory"), has been approved, subject to entering into a Franchise Agreement and paying the Initial |
| Franchise Fee. To continue the process of obtaining a franchise to operate a HealthSource Chiropractic |
| clinic in the Protected Territory, I am submitting this Franchise Deposit Acknowledgement (this |
| "Acknowledgement") and my deposit in the amount of $ (the "Deposit") to HealthSource. |
| Upon receipt of this signed Acknowledgement and the Deposit, HealthSource agrees to not grant the |
| Protected Territory to any third party until after, 20 (the "Deadline Date"), and to |
| provide me with access to certain training, information and materials relating to operating a HealthSource |
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- FDD. I have received the HealthSource Franchise Disclosure Document, and all Exhibits attached thereto, more than 14 calendar days before the date of my execution hereof.
Source: Item 23 — Receipts (FDD pages 77–282)
What This Means (2025 FDD)
According to the 2025 Healthsource Chiropractic Franchise Disclosure Document, the Franchise Deposit Acknowledgement is submitted when applying for a franchise.
The document states that upon receipt of the signed Acknowledgement and the deposit, Healthsource Chiropractic agrees not to grant the protected territory to any third party until after a specified date. They also agree to provide access to certain training, information, and materials related to operating a Healthsource Chiropractic clinic.
In addition, the marketing agreement between Healthsource Chiropractic and the franchisee requires a signature, date, and return of the agreement. The franchisee must also initial each item to signify responsibility for it. This agreement pertains to the use of HIPAA forms and other items supplied by HSC for marketing to patients, including patient authorization forms, electronic sign-in procedures, and the HSWorx Electronic Opt-In methods.