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Application for Credit & Consumer Credit Check

I/we understand that if I indicated that I wish to apply for Credit terms to pay monthly for the dental work not covered by the Grant, then the information submitted by me (the “Collected Information”) is being collected for the purpose of obtaining credit terms from Health Betterment Inc. (HBI) and is warranted to be true and complete.

HBI will use the Information you provide for the purpose of verifying your identity and to obtain your consumer credit bureau report as described below. 

The Information that you provide will be compared against the Information contained in the consumer credit report we access to help confirm your identity. The consumer credit report will also be used to assess your application for potential credit terms that may allow you to make longer term payments for the part of your dental work that's not covered by your insurance or the grant. The credit check may affect your credit score.

Accordingly, if you have requested credit terms from us, you hereby authorize and consent to the collection of the Collected Information and to the making by HBI, its successors and assigns of whatever credit investigations and/or employment and income confirmations HBI or its successors and assigns may deem appropriate from time to time, and to the disclosure, sharing or exchange of the Collected Information and any report or information based thereon for these purposes with credit reporting agencies, and amongst HBI, its successors and assigns or any company with whom I/we have or propose to have a financial relationship.

Should you qualify for consideration of a loan from us, credit terms between 6 months and 5 years will be offered to you and HBI will confirm acceptance with your participating dentist. If you do not qualify for credit terms, we may invite you to provide a suitable co-signer to guarantee your loan.

Should the Information you provide not match the Information contained in your consumer credit report, you will not be able to complete the pre-qualification process for credit terms, however you will still be approved for the Grant and can complete the dental work you want done by providing the dentist with an upfront deposit and agreeing to a payment schedule that is acceptable to the dentist.

Agreement & Consent to Use of Personal Information


I/we accept this as written notice of HEALTH BETTERMENT INC (“HBI”) its affiliates, service providers and professional advisors (collectively HBI) receiving, disclosing, exchanging and using any Collected Information and any other personal information (collectively the “Personal Information”) about me/us for the purposes set out below. HBI, its affiliates and service providers may use any Information relating to me/us:


a)            to establish, maintain and administer my/our account;

b)            to determine my/our eligibility for credit terms offered by HBI including monitoring my/our purchase history as well as evaluating my/our credit standing;

c)            to determine the suitability of benefits, services or enhancements; and/or which other product or service offers may be of interest to me/us;

d)            to promote and market additional products, goods and services offered by HBI including by means of direct marketing; &

e)            to comply with legal and regulatory requirements;

f)             for any other purpose not prohibited by law.


I/we hereby also authorize any person who is contacted in this regard to provide such information.


I /we acknowledge that my/our consent to “Use of Personal Information” includes HBI providing the dentist who accepts the case work for which I/we are applying (the “dentist”) with HBI’S decision with respect to this application and if my/our application is accepted, my/our Account number and any other information which the dentist may reasonably require.


All information provided by me/us in connection with this application is true, accurate and complete in all respects.


I/we consent to the creation of a Personal Information file containing credit and other personal information. Only those employees of HBI whose job functions involve assessment of creditworthiness, credit applications, monitoring, processing of payments and matters relating to the purpose of the file, will have access to my/our file.

I/we understand I/we can tell you to stop using Personal Information about me/us in order to promote and market additional products, goods and services offered by HBI. I agree that my/our Social Insurance Number may be used as an aid to identify me/us with credit bureaus and others for credit history file matching and other administrative purposes.


I/we also consent to the retention of Personal Information about me/us for as long as is needed for the purposes described above, even after I/we cease to be a customer. In order to ensure the accuracy, completeness and integrity of the credit reporting system, I/we specifically consent to the continued disclosure of my/our Personal Information to credit bureaus even after the loan or credit facility has been retired.

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