cosmetica payment

Online Application For Plastic Surgery Financing

Apply Now! We will find you the right payment plan, at the right rate.

Applicant Information

Our form uses high-grade 256 bit SSL encryption for secure (https) connections.

What procedure are you interested in?
(Choose all that apply)

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Applicant must be at least 18 years of age to apply!


Alimony, child support, or separate maintenance need not be included if applicant does not wish to rely on it. Gross Annual Income is income that applicant is able to use for repaying debts. Examples may include income earned from salaries, investments, rental properties, Social Security benefits and retirement accounts.

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Will you be using a Co-Applicant?
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Certify Information and Click Submit

Disclosures - Read the following statements:

(1) Upon submitting this application, I confirm that all submitted information found on this application is true and correct to the best of my knowledge, and allow Cosmetica Payment Plus and/or it's assignee(s) to verify the submitted information, including, but not limited to, attaining my credit report, making contact with my employer for employment and income verification.

(2) Furthermore, I am signing that Cosmetica Payment Plus may submit on my behalf and that I have read this disclosure and agree to the conditions set forth. I also agree that this application and any information I submitted with it may be forwarded to other creditors. I understand that any offer of credit from such other creditors will be independent of Cosmetica Payment Plus, I further agree that such other creditors may obtain a credit report and use it in making a credit decision.

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I certify that the above information was provided by me and I have provided all required notices and statements.