Medical Loan Request Form

The form below is for all types of medical loans. Please fill it out to the best of your ability. If you don't know what to put in a particular field, just leave it blank, with the exception of the * starred fields which are required. We really love funding medical projects! We have a GREAT lender for these, who can give you some great terms. We think you'll be very happy with the loan terms we can obtain for you.


After submitting the application, you will get a confirmation e-mail from us, followed by a phone call at our earliest convenience. The purpose of the phone call is for you to "meet" us, and for us to obtain any details that may be missing in your loan request.


If our underwriter likes what he sees on this short request, he will next ask for a lengthier form to be filled out (executive summary) and other documentation depending on your particular project. With a timely submission of these docs, we can often have you matched up with a lender with a quoted rate and terms within 3 business days!


If you have any questions at all, please call us at 1-800-602-9952 to speak with us directly. Thanks!

1. Borrower Information

2. Practice Information

3. Second Office

4. Existing Loan Balances

5. Education

6. Business Bank Info

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