Medicard's financing programs ensure that you don't delay your treatment due to cost concerns by offering you a variety of financing terms with convenient monthly payments.
We will pay your doctor or service provider in full now and you can repay us in affordable monthly payments.

With Medicard you get the best benefits:
  • High approval rate
  • Competitive interest rates
  • Quick, confidential process
  • Low monthly payments
  • No prepayment penalty

Fields marked with * are required fields.

General Information
You are: The Applicant The Cosignor  
If you checked Cosignor, please
indicate here who you are cosigning for: 		 
Mr. Mrs. Ms. Miss
First Name: *  
Middle Initial(s):  
Last Name: *  
Email Address:  
Date of Birth: * 19  
Social Insurance Number:  
Driver's License Number:  
Home Phone:  
Day Phone: *
Contact will be done confidentially		  
Fax Number:  
Call Before Fax? Yes No  

Current Address
Apt. Number:  
Address: *  
City & Province: *    
Postal Code: *  
Residing Since:    
Own Rent      
Monthly Payment:  
Landlord or Mortgage Company:  

Employment Information
Occupation:  
Employer:  
Employer Contact:  
Business Phone:  
Employee Since:    
Status:  
Gross Monthly Income:  
Net Monthly Income:  

Other Income
Source:  
Amount/Month:  

Bank
Name of Bank: Branch: Account Number:  

Procedure Information
Name of Patient: *  
Amount of Financing Required:  
Term:  
Procedure Type:  
Approx. Date of Procedure:  
Treatment Centre Name:  
Contact Person:  
Phone:  
Fax:  

Additional Information
If you require an immediate answer or have special instructions or information, please indicate in the space below:
If you have any further information, or have any questions, please contact us at 1-888-689-9876 and we will be happy to assist you.

Terms & Conditions


I/we understand that the above information (the "Collected Information") is being collected for the purpose of obtaining credit from Medicard Finance Inc. ("Medicard") and is warranted to be true and complete.  I/we hereby authorize and consent to the collection of the Collected Information and to the making by Medicard, its successors and assigns of whatever credit investigations and/or employment and income confirmations Medicard or its successors and assigns may deem appropriate from time to time, and to the disclosure, sharing or exchange of the Collected Information and any report or information based thereon for these purposes with credit reporting agencies, and amongst Medicard, its successors and assigns or any company with whom I/we have or propose to have a financial relationship.

I/we accept this as written notice of Medicard, its affiliates, service providers and professional advisors (collectively Medicard) receiving, disclosing, exchanging and using any Collected Information and any other personal information (collectively the "Personal Information") about me/us for the purposes set out below.

MEDICARD, its affiliates and service providers may use any Information relating to me/us:
a)   to establish, maintain and administer my/our Financing;
b)   to determine my/our eligibility for products, goods and services offered by MEDICARD including monitoring my/our purchase history as well as evaluating my/our credit standing;
c)   to determine the suitability of  benefits, services or enhancements, and/or which other product or
service offers may be of interest to me/us;
d)   to promote and market additional products, goods and services offered by MEDICARD including by means of direct marketing, &
e)   to comply with legal and regulatory requirements.

I/we hereby also authorize any person who is contacted in this regard to provide such information. 
I /we acknowledge that my/our consent to "Use of Personal Information" includes:
a)   MEDICARD providing the service provider who accepts the financing for which I/we am applying  (the "Retailer") with MEDICARD's decision with respect to this application and if my/our Card application is accepted, my/our Account number and any other information which the Retailer may reasonably require;
b)   The Retailer providing MEDICARD with information related to any loyalty or reward program offered by that retailer where such loyalty or reward programs is administered by MEDICARD and MEDICARD's receipt, exchange and use of such information.

Credit will be extended by MEDICARD upon approval of this application and I/we request an account card be issued to me/us and any renewal or replacements thereof.  All information provided by me/us in connection with this application is true, accurate and complete in all respects. All information provided by me/us in connection with this application is true, accurate and complete in all respects.

I/we consent to the creation of a Personal Information file containing credit and other personal information. Only those employees of MEDICARD whose job functions involve assessment of creditworthiness, credit applications, monitoring, processing of payments and matters relating to the purpose of the file, will have access to my/our file.
I/we understand I/we can tell you to stop using Personal Information about me/us in order to promote and market additional products, goods and services offered by MEDICARD. I agree that my/our Social Insurance Number may be used as an aid to identify me/us with credit bureaus and others for credit history file matching and other administrative purposes.

I/we also consent to the retention of Personal Information about me/us for as long as is needed for the purposes described above, even after I/we cease to be a customer. In order to ensure the accuracy, completeness and integrity of the credit reporting system, I/we specifically consent to the continued disclosure of my/our Personal Information to credit bureaus even after the loan or credit facility has been retired.


Medicard's professional and experienced staff are committed to helping patients obtain financing for the medical treatments they want.
Call us at 1-888-689-9876 if you have any questions or if we can be of assistance.

To finance your veterinary and dental treatments you can use Medicard or:

Applying for financing is as simple as filling out a short application form.

Apply now