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First Name
*
Last Name
*
Cell Phone Number
*
(
)
-
Email
*
Amount Requested
*
Purchase Type
*
Select...
Bariatric
Dental
Fertility
Functional Medicine
General Healthcare
Hair Restoration
Audiology
Med Spa
Medical Devices
Medical Tourism
Men's Wellness
Midwifery
Plastic Surgery/Cosmetic Surgery
Vision
Non-surgical Weightloss
Tax Relief
Timeshare Relief
Tutoring
Fitness
Home Improvement
Veterinary
Retail
Auto Service and Parts
Coaching
By providing my phone number and email and checking this box, I agree that United Credit and its partners may contact me about financing — including by autodialed or pre-recorded calls and text messages (SMS) at the number provided — for marketing and servicing purposes. Consent is not a condition of any purchase or financing. Message and data rates may apply; message frequency varies. Reply STOP to opt out, HELP for help. I also agree to United Credit's
Terms of Use
and
Privacy Policy
.
About your Provider
Enter Provider Name
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Enter Provider Details
We will contact them to see if they want to enroll with United Credit. If they do we'll send you a link to complete your application.
Provider's Name
*
City
*
State
*
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
The following information is optional but
highly recommend
to assist in contacting your provider.
Provider Email
Provider Phone
Provider Website
I authorize United Credit to contact the provider I named, on my behalf, to let them know I'm requesting financing for my care, and to share my name and the treatment I'm seeking for that purpose.
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Thanks!
We'll reach out to your provider about joining United Credit. As soon as they're set up we'll invite you to complete your financing request.
Sorry, your chosen Provider is not eligible for the United Credit program at this time.
Thank you for using United Credit