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Home Locate an Eye Surgeon Procedures Videos LASIK FAQ Articles Ask an Expert Blog July 25, 2008

Financing Your LASIK, PRK, IntraLase or Laser Eye Surgery Procedure



Q. What are the benefits of financing my LASIK or other corrective eye surgery procedure?

A. There are numerous benefits but the most popular is it allows you to have the surgery now versus waiting months or years to gather the money. You could have better vision in days rather than having to wait to save up the money!

There are ZERO interest programs as well.

Q. Does applying for the loan commit me to being financed?

A. Although numerous medical financing companies use the application process to commit you to the loan, we proudly can say that we do not do that in any way.

As a patient, the last thing you need is to feel pressure for such a huge personal decision. However, by simply applying for the loan it allows you, as the patient, to have a good understanding of exactly what your financial possibilities are.

Read more at our Financing FAQ. To apply for financing, please fill out the form below. 		  Search for a Corrective Eye Surgery Specialist
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Financing
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Eye Surgery USA Financing Application Form
All information kept in strictest privacy.

If you have a co-signer, be sure to check the "I WIll Also Have a Co-signer" box.
You will be able to enter co-signer information on the subsequent page.

Input information as completely as possible.
* indicates a required field.
The more complete the form, the quicker and more accurate the results.

PERSONAL INFO    
       
       
* Loan Amount: I Will Also Have a Co-signer
       
Your Down Payment Amount: *First Name:
M.I.:
*Last Name:
       
*Email Address:
*Social Security Number:
   Date of Birth:
       
* Current Address:
* City:
 * ST:
 *Zip:
       
  * Time at Current Address:
yrs, mos		 own
rent		 * Monthly Rent / Mortgage:
       
* Home Phone:
- - 		Alt. / Work Phone Number:
- - ext. 		Best Time To Call:
       
Married:
Yes    No 		Call This Phone:
Home  Alt./Work 		  Mother's Maiden Name:
       
       
       
Co-signer Application will appear on next screen if Co-signer box is checked
       
       
       
EMPLOYMENT INFO    
       
       
* Current Employer:
* Position:
 * Business Phone:
- -
       
Employer Address:
* Employer City:
 * ST:
 * Zip:
       
  * Time at Current Employer:
yrs, mos		   * Gross Monthly Income:
       
       
       
I HAVE ADDITIONAL INCOME TO BE CONSIDERED    
       
Other Income Amount
(Include Spouse's):
 Source of
Other Income:
  Have You
Declared Bankruptcy?
Yes       No
       
  Can you provide proof of this other income source? If so, in what form?
  If "Yes," In What Year?
       
       
       
IF YOU HAVE MOVED IN THE PAST 3 YEARS...  
       
       
Previous Address:
City:
 ST:
 Zip:
       
  Time at Previous Address:
yrs, mos		    
       
       
       
IF YOU HAVE CHANGED JOBS IN THE PAST 2 YEARS...
       
       
Previous Employer:
Position:
   Business Phone:
       
Employer Address:
Employer City:
 ST:
 Zip:
       
  Time at Previous Employer:
yrs, mos		    
       
       
       
PROCEDURE INFO  
       
       
Name of Eye Surgeon
(or check box below):
* Procedure in Which
You are Interested:
 Eye Surgeon's Phone
(if known; helps with approval):
- - ext.
       
Still choosing a surgeon?
Check the box below! 		Procedure Date
(if known):
    
       
← I wish to be contacted by a Laser Eye Surgeon serving my area
 
TIP: If you have yet to choose a surgeon, checking the box to have a
Screened and Highly Qualified LASIK and Laser Eye Surgeon contact you can speed the approval process
 
     
   
AUTHORIZATION TO RELEASE CREDIT INFORMATION
By submitting my application, I agree to have Eye Surgery USA's partnering loan processing company search all options for the best possible financing option. I completely understand that Eye Surgery USA uses a third party financing Broker, who will search for loans that fit my requirements based on loan amount requested along with credit history and other relevant factors.
   
   
When you have completed the form, click "Submit"
Form may take several seconds to process
 
 
 
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