Application - Doc2Doc Lending

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Loan Amount & Term

Step 1 of 6
Career Status *
Loan Amount
Loan Amount
Loan Type
* O1, H1B visa holders and Practicing Physicians are eligible for Principal repayment only
Loan Type
* O1, H1B visa holders and Practicing Physicians are eligible for Principal repayment only
Term
* The Standard monthly loan payment is calculated on principal plus interest for the full length of the loan. Hybrid monthly loan payments are calculated on interest only for the first half of the loan term, then principal plus interest for the second half of the loan term.

** Interest rates are subject to change
Purpose of Loan *
Other
Were you referred to Doc2Doc Lending?

Yes No
Referral Program Disclosure
By entering the referral code you agree that Doc2Doc Lending may share that information with your friend. If you would rather keep that information private, you do not have to participate in the referral program by simply not including the referral code.
Referral Number
First Name *
Last Name *
Email *
example@example.com

Personal Information

Step 2 of 6
Date of Birth *

Month Day Year
Are you a U.S citizen?

Yes No
Are you a permanent resident?

Yes No
Do you have an O-1 visa?

Yes No
Do you have a H-1 visa?

Yes No
Social Security Number *
If none, enter 000-00-0000
Member of the Military

No Yes

Contact Information

Step 3 of 6
Street Address *
State *
City *
Zip *
Country *
Are you Married?

Yes No
Spouse's Information
First Name
Last Name
Is your spouse's address the same as yours?

Yes No
Street Address *
City *
State *
Zip *
Country *
Phone *
^{To continue with your application please (scroll to the bottom) and agree to the TCPA disclosure below.}

Education

Step 4 of 6
Medical School
Dental School
Medical Specialty
Dental Specialty
Residency Program Institution
Residency Program Zip Code
Fellowship Sub-specialty
Fellowship Program Institution
Fellowship Program Zip Code
Years to Graduation
USMLE 1 Board Score
USMLE 2 Board Score
I took the COMLEX board examination, not the USMLE board examination

No Yes
COMLEX 1 Board Score
COMLEX 2 Board Score
NBDE 1 Board Score
NBDE 2 Board Score
Member of an Honors Society

Yes No
Additional Degrees

Work and Financial

Step 5 of 6
Current Employer *
Employer Zip Code *
Years in Practice after Training
Expected Residency Salary ($)
Do you own your own practice?

Yes No
* Annual Income ($) *
Enter your annual income (not household)
Monthly Housing Payment ($) *
(Please include property insurance, and/or property taxes)
Rent or Own

Rent Own
* Alimony, child support or seperate maintenance payment need not be revealed if Borrower does not wish to have it considered as a basis for repaying the loan

Terms and Conditions

Step 6 of 6
Should be Empty:

[1] To check the rates and terms you qualify for, Doc2Doc conducts a soft credit pull that will not affect your credit score.

Subject to credit approval, loans are made by Bank of lake Mills. Bank of Lake Mills may sell, assign, or transfer ownership of your loan to another party after the loan funds. The borrower will receive notification if and when any such sale, assignment, or transfer occurs. Bank of Lake Mills is member FDIC.

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