• ENT History Form
• Notice of Health Information Privacy Practices
• Notice of Privacy Practices Acknowledgement of Receipt
• Patient Insurance Assignment Responsibilities Acknowledgement
• Allergy Patient Medical History Form

CareCredit is different from a regular credit card. It helps you pay for out-of-pocket expenses not covered by medical insurance by extending special financing options that you can’t get when using your Visa or MasterCard.

With shorter term financing options of 6, 12, 18 or 24 months no interest is charged on purchases of $200 or more when you make the minimum monthly payments and pay the full amount due by the end of the promotional period. If you do not, interest is charged from the original purchase date.

For complete details, see the CareCredit account agreement within your application. Ask your provider to find out which promotion is right for you. You do not need to select a promotion before you apply.