Health Smart Financial Service

If you choose to proceed with a transaction, Health Smart will pay the provider directly.

Applicant Information



Personal Information



I agree, represent and warrant that the information I have given Health Smart Financial Services Inc. (“Health Smart”) on this application (and otherwise) is complete and accurate and understand that Health Smart is relying on that information. I authorize Health Smart and its partners and affiliates to collect credit, personal and other information provided on this application and from credit reporting agencies and other parties for the purposes of processing my application, and for administering any arrangements arising out of that application (the “Purposes”). I authorize the collection and exchange of information about me by Health Smart and its partners and affiliates for the Purposes, including the making of whatever credit investigations and/or employment and income references as Health Smart and its partners and affiliates may deem appropriate from time to time, and to sharing or exchange of reports and information with credit reporting agencies, or any company with whom I have or may propose to have a financial relationship.


 By checking this box, I acknowledge the above, and in furtherance thereto, specifically authorize Health Smart to disclose my approved credit limit and contact information to Avalon Animal Hospital, and to disclose the amount of my available credit from time to time.