Apply for Fiancing
All information is Confidential- You will be notified by email or by phone upon determination
If you are denined Mylbs has a Pre-Pay Option with Zero Interest that several clients chosen to use to obtain the surgical procedure.
Ask us about how you can apply for this option if you are turned down for any reason or
if you cannot get a co-signer for a line of credit.
YOU WILL BE GLAD YOU DID!
ALL FIELDS * MUST BE FILLED IN OR WE CANNOT PROCESS YOUR REQUEST!
Your credit card will not be billed with this form. Upon completing this form our financial managers will contact you and go over your options with you to see what will work best for your budget.
Every field is required in this application

Please Type in Your Full Name REQUIRED
Initial to Agree with Disclaimer REQUIRED
By electronically signing, I represent that I am at least 18 years of age and that the information I have supplied on this application is true and correct. I agree that I am applying for a Medical Line Account, provided by Obesity Resources Services and MyLapBandSurgery.Com use four different credit institutions they use for the purposes of financing surgical procedures they offer. This is to be considered after approval for the procedures and does not guarantee any loans this applications is solely for the purposes of getting the best possible rates available according my credit scoring and/or for personal, family or household use. I agree that a credit report may be obtained and used in making the credit granting decision. I agree to be bound by the terms and disclaimer of MyLapBandSurgery.Com and the terms by the Credit Card Agreement that I will receive upon approval.