How much would you like to borrow?

$

What's the purpose of the loan?

Debt Refinance/Consolidation Equipment Purchase Practice Acquisition/Expansion Start-up Practice Working Capital Other

What's your estimated credit score?

720 - 850 680 - 719 640 - 679 0 - 639

What's your estimated monthly income?

$40,000

$0 $100K+

What's your estimated monthly debt payments?

$12,000

$0 $50K+

Thanks! You're almost done.

While banks only care about your credit, our next section will focus on you and your practice - Because we know that you are more than just a number.

What best describes your role?

I am employed by a practice or system I am an owner or partner in a practice

How do you generate income?

Tell us about your employment structure

W2 1099 Both

How long have you been paid like this?

Less than one year More than one year More than two years

Who is your employer?

What's your employer's name?*

What best describes your employer?

For-profit Non-profit Public

What does your practice look like?

How long has it been in business? (in years)

What is your business zip code?

How many physicians are in the practice?

How many providers are in the practice?

Do you have any system affiliations or partnerships?

Yes No

What's the estimated monthly patient volume for the practice?

What is your payer mix?

How many payers is your practice working with?

Please estimate the percentage makeup of your payer mix

Private (%)

Medicare (%)

Medicaid (%)

Other (%)

Do you have insurance?

Check all that apply to you.

Life Disability Malpractice

What's your name?

This helps us customize your payment and pre-qualification

Please specify your specialty

4FiMD respects data privacy and will never sell your personal information. We also do not conduct a credit pull to estimate your monthly payment.

How can we reach you?

Email

Phone Number

I agree that 4FiMD may contact me by email, text, or phone with updates and offers. I can opt out anytime—details are in our Privacy Policy.

Your Estimated Offer

Requested Loan Amount: $50,000.00

Loan Purpose: —

Estimated Monthly Payment:

$1,304.56

36 Months 54 Months 120 Months

Please note that the payments and length of term above are estimates based on the information you provided and are subject to change.

Next Steps

Thank you for submitting your pre-qualification request. If you pre-qualify, you will receive an email within 24-48 hours with next steps.