To find out if you qualify for the LifeTrust line of credit, we would ask that you complete the following easily accessible forms below:
- Privacy and Confidentiality Policy (please read carefully)
- Initial Application
- Insurance Release of Information
- Medical Release of Information
- Physician or Healthcare Provider Statement of Capacity
- Fair Credit Billing Act Disclosure
Complete these forms online by clicking the form’s title above, then tab through and complete the requested information. You may also Print the forms and complete by hand, taking care to print the requested information clearly. These online forms are managed with the strictest concern for your privacy and information safety. Once completed, please print and sign each form.
You must forward the signed forms to LifeTrust by one of the following methods:
Fax to: 877.565.6313
Or
Mail to: LifeTrust, LLC
5300 Town and Country Blvd. Suite 160
Frisco, Texas 75034
Or
Email to apply@lifetrust.net
(you must be able to scan the completed and signed forms to attach to your email)
Should you encounter any difficulties with the forms, or you would prefer to have the forms mailed to you, please do not hesitate to call 877.565.6616
For your protection LifeTrust, does not retain or collect any of your information while you are using the online forms tool.