Application And Credit Card Account Agreement printable pdf download

Application And Credit Card Account Agreement

With CareCredit . . .

Start care immediately

Pay over time with low monthly payments

For yourself and your family

Types of Promotional Options that may be available:

Not all enrolled healthcare practices offer all special financing options, so please ask your practice to explain

which ones are available for your purchase.

No Interest if Paid in Full within 6, 12, 18 or 24 Months*

On qualifying purchases of $200 or more made with your CareCredit credit card account. Interest will be charged

to your account from the purchase date if the promotional purchase is not paid in full within the promotional

period. Purchases eligible for 6, 12 or 18 month promotions: Minimum Monthly Payments required. Purchases

eligible for a 24 Month promotion: Fixed Monthly Payments required until paid in full and based on repayment over

24 months. Required monthly payments may or may not pay off purchase before end of promotional period.

14.90% APR and Fixed Monthly Payments Required Until Paid in Full**

On qualifying purchases made with your CareCredit credit card account. Fixed monthly payment amount based

on repayment over 24, 36, 48 or 60 month period. Purchases of $1000 or more are eligible for a 24, 36 or 48

month offer and purchases of $2500 or more are eligible for a 60 month offer.

*, ** See Page 10 for details

Step 1 Please follow these guidelines when completing your application:

Please have available two forms of ID that can be verified: one primary ID and one secondary ID

or two primary IDs. If using a joint applicant, the joint applicant must be present and also provide

two forms of ID.

Acceptable primary IDs are State issued driver’s license (preferred), government issued ID, Non-Driver

State issued ID, Passport, Military ID or Government issued Green/Resident Alien card. Acceptable secondary IDs are Visa,

MasterCard, American Express, Discover, department store or an oil company credit card with an expiration date.

Please include all forms of income from all full and part-time jobs, bonuses, commissions, and

investments.

You need only include child support, alimony, or separate maintenance income if you wish this income to

be considered in your application.

Please note that you must reside in the United States and be 18 years or older to apply.

Step 2 Please complete the rest of the application on the reverse side

182-077-00

Revision Date: 062413

Application And Credit Card Account Agreement