AllMedFund™: Get Pre-Approved

Pre-Approval Form

To get pre-approved, please complete the following form. We can let you know within 24 hours if you qualify for our AllMedFund™ program. * - indicates required field your name:* company name:* open insurance receivables:* $ open patient receivables:* $ average monthly sales:* $ avg. invoice turnaround (# of days):* days are your receivables currently pledged as collateral on any loan?:* No Yes email address:* phone number:*