Medicard was founded in 1996 with the goal of making elective health care financing a convenient alternative for health care providers and patients alike.
We make patient financing simple, flexible, fast, friendly and convenient with an easy application process, low monthly payments, and competitive interest rates.

With Medicard your practice or business gets the best benefits:

  • NO SET UP COSTS
  • NO FEES
  • Guaranteed immediate payment
  • Effective marketing tool
  • High approval rates
  • No collection problems
  • No recourse

Fields marked with * are required fields.

Transaction Information
Equipment Make:  
Equipment Model:  
  New   Used  
Vendor: *  
Contact:  
Equipment Cost : *  
Lease Term:  
Equipment Description :

 

Business Information
Business Type :  
Other:  
Street Address: *  
City & Province: *    
Postal Code:  
Business Phone: *  
Fax Number:  
E-mail address:  
Date Established: *     19  
Business Name: *
(Legal name in full) 		 
Trading Name:
(If different than above) 		 

Bank Information
Name of Bank: Branch: Chequing Account Number:

Trade References
Company:  
Contact Name:  
Phone:  


 
Company:  
Contact Name:  
Phone:  

Owner's Personal Information
Mr. Mrs. Ms. Miss
First Name: *  
Middle Initial(s):  
Last Name: *  
Date of Birth: * 19  
Home Address: *  
City & Province: *    
Postal Code: *  
Home Phone:  
Social Insurance Number:  
Gross Annual Income: *  
Own/Rent Home: Own Rent  
Monthly Payment:  

Additional Information
If you have any 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

The above information is for the purpose of obtaining credit and is warranted to be true and complete. I hereby authorize and consent to the receipt and exchange of information about me by MEDICARD FINANCE INC. (MEDICARD) and its affiliates from time to time as MEDICARD may deem appropriate, including the making by MEDICARD and its affiliates of whatever credit investigations MEDICARD may deem appropriate from time to time, and to the sharing or exchange of reports and information with credit reporting agencies, personal information agents, credit bureaus, and/or any other person, corporation, firm or enterprise with whom I have or propose to have a financial relationship.
Pressing the SUBMIT APPLICATION button below, signifies compliance to all terms, and acknowledges you have read and agree with all disclaimers presented herein.