* = Required Information

Appointment Confirmation

Thank you for contacting ABI and for the privilege of allowing us to provide you with professional business services. At ABI, we recognize how valuable you are as a client.

TERMS

ABI is a preferred group of professionals that network comprehensively to complete our client’s project. We are committed and dedicated to helping you achieve your goals. Pursuant to the Intake, a non- refundable consultation fee for Application, Business Assessment, and Market Analysis is required in the amount of five thousand dollars ($5,000); and two hundred fifty dollars ($250) for each additional person. The fee is required 24 hours prior to the Intake, in certified funds. The appointment may take up to one hour, The Intake fee is required: 24 hours prior to intake, in certified funds and are non-refundable. This is not a solicitation or offer to fund.

Corporate Policy (Provider Applicants)

ABI does not directly or indirectly accept payments from: Grants, Federal, or State Health Care Funded Programs (such as Medicare, Medicaid/Waiver, Veterans Administration, Tricare, etc.) for contracts with a business entity. Clients will not make payments to ABI from any Federal or State Grant Funded Programs for any services rendered. Payment must be made to consultant directly from the client. All Payments must be made payable Directly to ABI and in accordance with the terms embodied in this agreement.

No credit card or electronic payment methods accepted, certified funds only.

I have read and agree to comply with ABI’s terms as written.

Officers/Partners Personal Information

Partner

Financial Responsibility Information

Yes No
Yes No
Yes No
Yes No
Credit Funds
Revenue Equity Both
Yes No
Yes No

Business Credit

Personal Credit

Yes No
Yes No

Management Information

Start-Up Business Information

Existing Business Information

Yes No
Yes No
Yes No

Product Development Services

Yes No
Yes No
Yes No
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Yes No
New business start-up Credentialing Services Operations Site
Audits/Survey/Inspections Business Expansion Training/Materials
Re-Engineering/Mergers Accreditation Assistance Business Sale/Purchase
Policy Update/Modification Establish a Corporation Certifications
Corporate Credit Building Staffing Assistance Business Accounts
Furnishings/Supplies/Equipment Business Model/Plan Licensing/Permit
Registrations Marketing/Advertising/Branding Policy/Procedure Development
Web Design/Business Cards/Flyers Relationships/Resources Grant/State Loan Assistance
Turnkey/Interior Designer Bids/Proposals/Revenue Contracts
Formulation Development
Programming Prototype
Manufacturing Distribution
Product Placement Contract Procurement

Funding, Contracts & Certifications Requirements

A minimum of 2 years of business credibility, EIN with established credit is required.

Yes No

I acknowledge ABI uses third party professional services. I authorize the release of information to engage third party services. I certify the information provided herein is complete and accurate.

I consent to the collection, use, storage, and processing of my personal and, where applicable, health-related information, including any data I submit on behalf of others, for the purpose of managing my inquiry, order, account, or subscription. This includes order fulfillment, payment processing, and customer service, in accordance with the Privacy Policy.