Financing for Weight loss surgery Cosmetic Plastic Surgery, Bariatric Surgery, LapBand, Gastric Sleeve Bypass, Breast Augmentation, Reduction Liposuction

MyLapBandSurgery.Com
If your credit is below 600 you will need a Co-Signer Automatically.
If you can not get a Co-Signer and really need assistance's, My Lap Band Surgery Inc. has a unique program to help you get your surgery. It's called the "Pay Before You Go Program" There is no fees, no interest to worry about, NO PROOF OF EMPLOYEMENT, NO CREDIT CHECK! You simply pay a low affordable monthly payment that fits your budget that you choose before you go for your surgery. We have several clients using this program and it actually SAVED THEM A LOT OF CASH!
Call if you would like to apply for this program. CALL TOLL FREE 1-866-309-0036

Financing Available
We have several different financial institutions that we use to help our clients get the best possible loan and interest rates programs they offer.

We also accept Visa,Master Card,Discover and American Epxress.

We offer different payment plans by MyLapBandSurgery.Com that works for any ones budget and for those who can not get financing at all. Call our Coordinators today and ask them for more details about how you can get your surgery with our No Interest low monthly Payment Plan Programs.

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

All fields are required to process your application
Check One Only :	Are You The Borrower?
	Are You The Co-Signer?

If you are the Co Signer, please type the patients full name below that your co signing for:
	Patients Full Name:

Title
First Name
Middle
Last
(DOB)
S. S. # Number
Email:
Address:
Address 2
City
State		Zip Code
Phone Including Area Code		Cell:
Best time to call:
This is?
Type of Loan?
Date of Surgery?
Loan Amount?
Monthly - Annual Income		Monthly	Annual
Additional Income?
Rent/Mortgage Amount $
Click One	Rent Own Other
How long at current address

Employer's Name
Years Employed
Positon
Business Phone
Credit Card Check
Card Number


Please Type in Your Full Name to Agree with Disclaimer 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 MyLapBandSurgery.Com and the 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.