CALL US 888-601-6040

Financing Form

Fast & Easy Qualifying And Loan Approval

We are pleased to offer assistance in securing loans for your stay at KLEAN West Hollywood through our financing partner, Clark Behavioral Health Financing. Clark Financing excels at putting together an affordable and attractive package for clients or their loved ones who would like to spread the cost of the program over time.

Interest rates are still at all-time lows, making these loans even more attractive to clients who do not want to incur treatment costs all at once.

Your Monthly Payment May Be Less Than $400 a Month!

This is the most affordable way to enroll yourself or a family member at KLEAN West Hollywood. We encourage you to call us at 888-601-6040 or submit the pre-qualification form to the right to find out if you pre-qualify. You are under NO obligation to move forward with the loan - so this is a risk-free way to find out if this is the right option for you or your family.

Loans Are Pre-Approved within 24 Hours*

Custom Loans offers:
  • Medical Loans
  • Unsecured Loans
  • Unsecured Lines of Credit

Qualifying Factors

  • Credit score of 650 or higher
  • 1-3 years of positive credit history
  • Verifiable income
  • U.S. citizen
  • Co-signers may be accepted if your credit score does not qualify

Call Toll-Free 888-601-6040

*Loans pre-approved within 24 hours if received during normal business hours Monday-Friday.

Call Toll-Free 888-601-6040

or fill out our pre-qualification form

**Our strict privacy policy keeps your personal information safe and secure.

Required fields are indicated by an *

First Name:*
Last Name:*
Email Address:*
Birth Date:*
Address:*
City:*
State:*
Zip/Postal Code:*
Main Phone:*
Secondary Phone:
Gross Monthly Income:* $
 Check here if you are self employed
 Check here if there may be a co-signer
Client/Student Name:
Admissions Counselor:
Facility/Program you are interested in:*
By checking this box I am authorizing Clark Behavioral Health Financing, Inc to obtain a credit report to see if I pre-qualify for a loan. I understand that this is a pre-qualification form and not a complete loan application. I have read the statement below regarding consent and authorization to obtain consumer reports.
Signature:*
Type your name as your signature
I understand that (1) consumer reports (credit reports) may be obtained in connection with my Loan Application, (2) if I request, I will be informed whether or not consumer reports are obtained, and (3) if reports are obtained, if I request, I will be informed of the names and addresses of the consumer reporting agencies (credit bureaus) that furnish the reports. If this application is approved, subsequent consumer reports may be requested or used in connection with an update, renewal, or extension of the credit for which I have applied. I (we) have completed this application to obtain credit, and certify that the above statements are true and complete. I (we) authorize Clark Behavioral Health Financing, Inc. to check my (our) credit references and to obtain credit report(s). I (we) also authorize Clark Behavioral Health Financing, Inc. to provide credit report(s), personal and financial information provided with this application and credit mortgage information arising from this transaction to the facility listed above. I (we) authorize the facility listed above to release to the lending institution, subsequent holder or their agents, any requested information pertinent to this loan application (e.g. employment, enrollment status, prior loan history, current address). I certify that the proceeds of this loan will be used for treatment purposes at the treatment facility listed on this application. See your Promissory Note for notices to California, Ohio and Wisconsin residents. Even if I (we) have elected to opt out of information sharing or do so in the future, I (we) understand and agree this consent authorizes Clark Behavioral Health Financing, Inc. to share this information for purposes of processing this application and servicing any resulting loan.
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888-601-6040