Practice Details By atlanticcom August 8, 2019October 3, 2019 Application Step 1 of 3 - About You 0% About YouName* First Last Email* Phone*Field of Practice*Select OneDentistVeterinarianOpthamologistEstimated Credit Score*Select One800+750-799700-749650-699600-649Below 600 About Your PracticeBusiness Name*Legal EntityWebsite Practice Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Practice AddressHow Many Years in Business?*12345678910 or moreEstimated Yearly Collections*Does the practice have outstanding debt?*YesNoIf Yes, How Much?* About Your RequestType of Financing Requested*Select OnePractice AquisitionPractice RefinancePractice ExpansionReal Estate FinancingTotal Amount of Financing Requested*How Did You Hear About Us?*Select OneWebsiteSocial MediaEmailReferralSearch EngineMailerAdditional CommentsConsent* I agree to the privacy policy.I agree to be contacted by a representative to discuss my application. My information will not be shared with any non-related, outside party. I agree to receive marketing and promotional emails that I have the ability to opt out of at any time.
