Financing Application Form

At Cosmedica, we believe you're entitled to the confidence and satisfaction that comes with looking your best. Dr. Weiglein and his staff support your desire to enhance your appearance and we've created an environment where you'll find encouragement and empowerment on your cosmetic journey.

Medicard is Canada's premier cosmetic procedure financing company and we are proud to be partnered with Cosmedica.

With Medicard, you can start your transformation with Dr. Otto Weiglein, today. With terms up to 6 years, Medicard offers a variety of options to help pay for your cosmetic procedure needs. Your equal monthly payments will be customized to suit your budget. It's that easy!

Simply fill out the application form below ... or you can call us at 1-888-689-9876 and speak with one of our friendly staff members. Go ahead ... Now you can afford to!

Financing Application Form

Begin the application

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About You


Current Address

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Procedure information

Employment information

Other income


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Additional information

If you have any further information, or have any questions, please contact us at and we will be happy to assist you.

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