1. Step1Application Info
  2. Step2Plan Selection
  3. Step3Plan Confirmation

See your payment plan options with Park View Dental(Kenneth Mitchell)

Loan Amount and Patient Info
Please enter the amount you need.
Applicant address

Applicant Information

Home Address
Is your mailing address the same as your home address?
Applicant Details
  • Some examples of income include the following:

  • Income from employment, including full-time, part-time, freelance, or seasonal jobs

  • Self-employment, including any business dividends or rental income

  • Any other income such as retirement, social security, or public assistance

  • Important notes:

  • • Non-taxable income, if included, should be increased by 25%.

  • • Alimony, child support or separate maintenance income need not to be included if you do not wish to have it considered as a basis for repaying this obligation.

  • • Married Wisconsin Residents Only: If you are applying for an individual account and your spouse is also a WI resident, combine your and your spouse’s financial information.

Application Disclosures
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