Now is the Right Time To Invest in Your Business

Your Trusted Healthcare Financing Partner and Resource for more than 40 Years
Competitive Loan and Lease Rates for Equipment Acquisition • Working Capital • Supply Purchases
Practice Start Ups and Expansions • Practice Acquisitions and Loan Consolidations
Owner Occupied Mortgage Financing • SBA loans

Secure Quick Credit Application
The financing is intended for business or professional use only.
Please fill this application out completely, enter "NA" when not applicable
Need help or have quesetions on this form? Please contact us
Office: 800.336.8562 | Fax: 800.987.7713
Total Loan Amount Requested:
Financing Programs
* Financing Type:
The financing is intended for business or professional use only.
Equipment Description (if applicable):
* Preferred Financing Program:
For non-real estate loans
Loan Lease
Deferred Not Deferred

Business information
Legal Business Name:
Business Address:
City, State, Zip: ,
Tax ID Number(Leave blank if not immedately known):
Business Phone: - -
Year business established:
Owner information
Your Name (as it appears on your Drivers License):
Your Ownership %:
Include all legal owners with 20% or more ownership
Social Security #: - -
Date of Birth:
Medical / Dental License Number:
Year Licensed:
Are You A U.S. Citizen: Yes / No
Do You Own Another Established Business: Yes / No
Your Home Address:
City, State, Zip: ,
Mobile Phone: - -
Other Information
Supplier Name / Equipment Dealer:
Supplier Contact:
Supplier Contact Phone or Email:
GFS Representative
(If Known):
Additional Information:
Permission Statement
You understand by clicking the “I Accept “ button following this notice you are providing “written instructions” to allow GROUP FINANCIAL SERVICES to obtain information on your personal credit profile and public records sources. I hereby understand and authorize our banks, consumer agencies, trade references, and financial institutions to compile and furnish any information pertaining to our credit and financial responsibilities as requested by GROUP FINANCIAL SERVICES or its assigns and photostatic, facsimile, or other electronic copies of this authorization may be submitted to obtain the release of this information.
I accept

All programs, rates, terms and amounts are subject to equipment review, credit approval, professional time licensed and business verifications. Other terms and structures may be available upon request. First payment (unless deferred) and small processing fee due with final contract. All payments are subject to any applicable sales tax and shipping. Call for terms on tractions under $10,000. Upon approval terms are confirmed but rates may be subject to change at the first of each month based on reflected changes in Like U.S. Treasuries Rates and Federal Reserves Rates and date of final loan closing. Rate and term are fixed once loan closes. Deferred options are not same as cash programs. Deferred options are fixed rate finance agreements with low payments for the first selected deferral months.

A Group Financial Services representative will contact you shortly to discuss your application and the terms available for your equipment or project needs. We offer terms from 12 Months up to 10 years and will structure the best program to fit your needs.

Submitting this form does not obligate you to take any of our loan packages.

Please do not hesitate to contact us with any questions.
Call Us Toll Free: 1-800-336-8562