Fee Agreement and Patient Registration
Please review the following before you apply:
Attention Healthcare Provider. Please use the contact form below to register the Applicant prior to completing the online application. Also, please remember to add our loan set up fee as outlined below to the amount of the loan being requested.
- Loan amounts up to $9,999.99 / The fee is $375
- Loan amounts from $10,000 to $24,999.99 / The fee is $575
- Loan amounts of $25,000 and up / The fee is $775