Step 1 Apply for Financing

The Bariatric Connection.Com
If your credit is below 650 you will need a Co-Signer Automatically.
If you cannot get a Co-Signer and really need assistance's,TheBariatricConnection.Com has a unique program to help you get your surgery. It's called the "Pre-Pay 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 1-866-924-5417

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, Wire Transfer, Money Order and Certified Checks

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

STEP 1 FILL OUT THE FORM BELOW TO SEE IF YOU QUALIFY

Fill in all * required fields.

Full Name	*Required
Address	*Required
2nd Address
City	* Required
State	* Required
Zip Code	*Required

Phone	* Required
This Number is
Email	* Required
Alt. Email
I need more info.	* Required
Schedule an Appointment	*Required
Select a day	* Required
I am interested in
I am interested in Cosmetic
Must Check	* I have read and accept disclaimer terms & conditions and am in agreement with it them. Required
Type Initials	* Initials Required I understand and agree by signing electronically my initials of my name that I have read the disclaimer and terms and conditions ,and am in agreement with them.

Step 2
Your credit card will not be billed with this form!
Upon completing this form the financial managers will contact you and go over your options with you to see what will work best for your budget.


*Required	Patients Full Name:

Title
First Name	*Required
Middle
Last	*Required
(DOB)	*Required
S. S. # Number	*Required
Email:	*Required
Address:	*Required
Address 2
City	*Required
State		Zip Code	*Required
Type of Loan?	*Required
Date of Surgery?	*Required
Loan Amount?	*Required
Annual Income
Rent/Mortgage Amount $	*Required
Click One	Rent Own Other *Required
How long at current address	*Required
Employer's Name	*Required
How long	*Required
Business Phone	*Required
Credit Card Check	*Required
Card Number	*Required
Must Sign Below: *Required
Please Type in Your Full Name Initial 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 Credit Line Account, provided by The Bariatric Connection.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 The Bariatric Connection.Com and the terms by the Credit Card Agreement that I will receive upon approval.

Gastric Sleeve Lap Band Gastric Bypass Affordable, Safe State of the Art American Owned Hospital