Please print, read and fill out the following forms. Bring them with you to your appointment.
If you’ve chosen a procedure not covered by insurance (or if your insurance doesn’t cover all the costs of your medical procedure) CareCredit offers convenient payment options so you can get the procedure you want, when you want it. It’s easy to apply.
- Low monthly payment plans
- No money down
- No penalty for early pay off
- No annual fees
- No Application fee
- The application process is fast, easy and confidential!
Earn Rewards and save money! The Brilliant Distinctions® Points Program allows you to earn points for your eligible Botox®, Juvederm® XC and Latisse® purchases. Your points are redeemable for savings on future Botox and Juvederm XC treatments as well as the purchase of Latisse for longer, thicker lashes.