Citerra Loan Application

1
First, we'll get a few basic questions out of the way.* This field is required.You will need a minimum credit score of 650 from Trans Union .
Enter your First and Last name.
Enter your Email Address.
Enter your Phone Number
2
Enter the name of the doctor, practice or medical tourism company performing the surgery* This field is required.Don't have one yet? Type "recommend" in the box below and we can send over our recommended surgeons list.
Doctor or Practice Name
3
Add all household income (per year basis). * This field is required.Note: cosigners cannot be added on your application - but please add all household incomes to your income (ex. your spouse, common law husband/wife, same sex, need not be married) Include all earning members living under the same roof (their income can be added to yours). Example, if you're making $600/week, your spouse makes $500/week, earning members that live under the same roof make an additional $900/week, then you add them all up for $2000/week. Then take this number and multiply it by 52 weeks in the year and that gives you a total yearly household income of $104,000.
Total Annual Household Income
4
Surgery and Travel Financing Amounts* This field is required.Enter the amount you'll be financing of your surgery and travel without dollar signs or commas in their respective boxes below.
Amount of Surgery Financing (do not use dollar signs)
Amount of Travel Financing (do not use dollar signs)
5
This is your total financing amount. Please write this down, you will need to input this in the final application. Click Submit to Continue.* This field is required.
6
Terms and Conditions Agreement* This field is required.After you click submit below, you'll be asked to provide the previous amount in our secure platform. This amount includes all fees associated with the loan. Please read and accept our terms and conditions agreement below to get started.
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