---
title: Cosmetic Surgery Financing Application Form Template | Paperform
description: Professional cosmetic surgery financing application form template with procedure costs, payment terms, surgeon credentials, and consent fields. GDPR compliant and fully customizable.
url: "https://paperform.co/templates/cosmetic-surgery-financing-application"
type: static
generatedAt: "2026-03-28T00:43:31.089Z"
---

[← Back to free form templates](/templates/)    ![Cosmetic Surgery Financing Application](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cosmetic-surgery-financing-application.png)
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### Streamline Your Cosmetic Surgery Financing with Paperform

Finding the right financing option shouldn't stand between your patients and the procedures they desire. Our **Cosmetic Surgery Financing Application** template is designed specifically for plastic surgery practices, medical spas, and cosmetic clinics that want to offer flexible payment solutions while maintaining a professional, reassuring patient experience.

#### Why This Template Works for Cosmetic Surgery Practices

Cosmetic procedures represent a significant investment for most patients, and offering clear, accessible financing options can be the difference between a consultation and a confirmed surgery. This template creates a seamless application process that captures all the essential information—from procedure selection and cost estimates to employment verification and payment preferences—in one beautifully designed form that reflects the premium nature of your practice.

Unlike generic loan applications that feel impersonal and intimidating, this form is tailored specifically to the cosmetic surgery journey. It acknowledges the sensitive nature of aesthetic procedures while efficiently collecting the financial and medical information needed to process financing quickly.

#### Key Features That Make Financing Simple

**Comprehensive Procedure Selection**: Patients can select from common cosmetic procedures with associated cost ranges, making it easy to estimate financing needs upfront. The form supports everything from facial procedures like rhinoplasty and facelifts to body contouring options like liposuction and tummy tucks, with clear pricing transparency.

**Surgeon Credential Documentation**: Built-in fields capture your surgeon's board certifications, credentials, and practice information, ensuring financing companies have the verification they need while reinforcing your practice's credibility and expertise.

**Financial Qualification Assessment**: The application collects employment details, income information, and financial obligations in a respectful, straightforward manner that helps determine appropriate financing options without making applicants feel uncomfortable.

**Flexible Payment Terms**: Patients can indicate their preferred payment structure, from interest-free short-term plans to extended monthly payment options, allowing you to match financing solutions to individual budgets and circumstances.

**Media Release and Gallery Consent**: Integrated consent fields for before-and-after photography and marketing use, streamlining the permissions process while patients are already thinking about their procedure journey.

#### Perfect for Multiple Healthcare Settings

This template serves a variety of aesthetic medical professionals:

 - **Plastic surgery practices** offering major reconstructive and cosmetic procedures
 - **Medical spas and dermatology clinics** providing non-invasive treatments and injectables
 - **Dental practices** specializing in cosmetic dentistry and smile makeovers
 - **Hair restoration centers** offering transplant and restoration treatments
 - **Ophthalmology practices** performing LASIK and cosmetic eye procedures

#### Automate Your Financing Workflow with Stepper

Once a patient submits their financing application, **[Stepper](https://stepper.io)** can automatically orchestrate your entire approval workflow. Route applications to your finance team for review, send information to third-party financing partners like CareCredit or Prosper Healthcare Lending, trigger credit checks, and notify patients of approval status—all without manual data entry.

Stepper can even create conditional pathways: approved applications trigger welcome emails and booking links, while applications needing additional information automatically generate follow-up requests. This means faster approvals, better patient communication, and more procedures scheduled with less administrative overhead.

#### Collect Deposits and Initial Payments Seamlessly

Paperform's built-in payment integrations with Stripe, PayPal, and Square mean you can collect consultation fees, deposit payments, or even full procedure costs directly through the form. Add product fields for different procedure packages, calculate totals with financing fees automatically, and provide patients with instant payment confirmation—all within the same beautiful form experience.

#### Brand Your Financing Experience

Your financing application should feel like a natural extension of your practice's brand, not a jarring third-party form. Paperform's document-style editor lets you customize fonts, colors, imagery, and layout to match your website perfectly. Add calming background imagery, embed your logo, and use your brand's color palette to create an application experience that reinforces trust and professionalism.

#### GDPR Compliant and Secure

When handling sensitive financial and medical information, security isn't optional. Paperform is SOC 2 Type II certified and GDPR compliant, with SSL encryption protecting all data in transit. You can confidently collect social security numbers, income details, and medical information knowing it's handled with bank-level security.

*Please note: While Paperform provides robust security features, it is not currently HIPAA compliant. For practices requiring HIPAA compliance for protected health information, please consult with your compliance officer about appropriate use cases.*

#### Who Benefits Most from This Template

This financing application template is ideal for:

 - **Cosmetic surgery practices** looking to increase procedure bookings by removing financial barriers
 - **Medical spa directors** wanting to offer financing for package deals and treatment series
 - **Practice managers** seeking to streamline the application and approval process
 - **Patient coordinators** who spend too much time manually collecting financial information
 - **Multi-location aesthetic practices** needing consistent financing processes across offices

#### Get Started in Minutes

With Paperform's 30,000+ form templates and AI-powered form builder, you can launch your cosmetic surgery financing application today. Customize procedure options for your specific services, adjust payment terms to match your financing partners, add conditional logic to show relevant questions based on procedure selection, and start accepting applications immediately.

Trusted by healthcare providers worldwide, Paperform makes it easy to offer the professional, compassionate financing experience your patients deserve—without the complexity of traditional loan application systems.

**Ready to make cosmetic procedures more accessible?** Start with this template and begin accepting financing applications in minutes, not weeks.
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