Alphaeon Credit Account Application

Step 1: Application

Cardmember Benefits:

Special financing option** for purchases of $250 or more and credit limits up to $35,000 with the ability to use your card again at thousands of doctors' offices nationwide.

Note: The Alphaeon Credit Card account is issued by Comenity Capital Bank. Review our Financial Privacy Policy and Online and California Privacy Policy for more information. California Residents: Visit this page to request that we Do Not Sell My Personal Information.

Your Personal Information

First Name

MI (optional)

Last Name

Suffix (optional)

-Select One-

Social Security Number

Why do you need my Social Security number?

We use this information to verify your identity and obtain credit bureau information.

Date of Birth

Annual Income

Why do you need my income?

In order to comply with federal law, and to determine factors such as your credit limit, we consider your ability to meet the payment obligations associated with this account. Your income information is part of that consideration.

If you do not wish to have alimony, child support and/or separate maintenance income considered as a basis for repaying this obligation, please do not include it in your Annual Income amount. Married WI Residents only: If you are applying for an individual account and your spouse also is a WI resident, combine your and your spouse's financial information.

Intended Purchase Amount (optional)

Intended Purchase Amount is the amount you plan to spend on your first purchase with this credit card, if you submit an application and your application is approved. Enter as a dollar amount with no dollar sign or decimal like this: 2000 for $2,000.00

Contact Information

Zip Code

Street Address

PO Box mailing addresses are not accepted.

Suite or Apartment (optional)

City

State

-Select One-

Email Address

Confirm Email Address

Mobile Phone

Alternate Phone

By providing your contact information, including any mobile or other phone numbers, you agree to be contacted regarding any of your Comenity Bank or Comenity Capital Bank accounts via calls to cell phones, text messages or telephone calls, including the use of artificial or pre-recorded message calls, as well as calls made via automatic telephone dialing systems or via email.

Continue

Cardmember Benefits:

Patient Financing with Board Certified Plastic Surgeons and Dermatologists

Special financing** everyday on purchases of $250 or more
Credit lines up to $35,000
Online application process with instant approvals

YOUR BEST YOU IS CLOSER THAN YOU THINK – LOOK, FEEL, AND BE YOUR BEST WITH Alphaeon CREDIT!

Alphaeon Credit offers many types of financing options. Not all plans are available in all physicians' offices, and additional plans may be offered. Ask your physician's office for more details.

Deferred Interest, Payment Required plan:

No Interest if paid in full within 6, 12, 18, or 24 months months.

On purchases of $250 for 6 months and $500 for 12, 18, and 24 months made with your Alphaeon Credit Card.

Interest will be charged to your Account from the purchase date if the promotional plan balance is not paid in full within the promotional period^.

Low APR, Equal Payment plan:

14.99% APR for 24, 36, 48, or 60 months. After that, purchase APR of 28.99%.

On purchases of $1,000 or more for 24, 36, or 48 months, $2500 or more for 60 months made with your Alphaeon Credit Card^^.

**Minimum payments are required for each Credit Plan. Valid for single transaction only.

^Deferred Interest, Payment Required plan: Interest will be charged to your Account from the purchase date if the promotional plan balance is not paid in full within the promotional period. Minimum payments are required for each Credit Plan. Minimum payments are NOT guaranteed to pay the promotional plan balance within the promotional period. You may have to pay more than the minimum payment to avoid accrued interest charges.*

^^Low APR, Equal Payment plan: Interest will be charged to your Account at the reduced APR from the purchase date through the end of the promotional period. After the promotional plan expiration date, the purchase APR will apply. Minimum payments are required for each Credit Plan.*

*All Promotional Plans:

Valid for single transaction only. As of 10/2020, terms for new Accounts: Purchase APR of 28.99%. Minimum interest charge is $2 per Credit Plan in any billing period in which interest is due. Existing Cardholders: see your credit card agreement for Account terms.

Credit card offers are subject to credit approval.

Alphaeon Credit Card Accounts are issued by Comenity Capital Bank.

What is a credit report? A credit report is a record of your credit history. It includes information about whether you pay your bills on time and how much you owe to creditors.

How did we use your credit report? We used information from your credit report to set the terms of the credit we are offering you, such as the Annual Percentage Rate. The terms offered to you may be less favorable than the terms offered to consumers who have better credit histories.

What if there are mistakes in your credit report? You have a right to dispute any inaccurate information in your credit report.

If you find mistakes on your credit report, contact the consumer reporting agency listed below, which is the agency from which we obtained your credit report. It is a good idea to check your credit report regularly to make sure the information it contains is accurate.

How can you obtain a copy of your credit report? Under federal law, you have the right to obtain a copy of your credit report without charge for 60 days after you receive this notice. To obtain your free report, contact:

How can you get more information about credit reports? For more information about credit reports and your rights under federal law, visit the Federal Reserve Board's web site at www.federalreserve.gov or the Federal Trade Commission's web site at www.ftc.gov.

What you should know about credit scores. Your credit score is a number that reflects the information in your credit report. Your credit score can change, depending on how your credit history changes.

Your credit score as of 10/28/2021: 0

We used your credit score to set the terms of credit we are offering you. In the scoring system we used, scores can range from 479 to the best possible score, 898. Please be aware, there are a number of different credit scoring systems available, and each uses a different range of numbers.

Here are the most significant factors in determining your score:

If you have questions about the factors impacting your credit score, we encourage you to contact the consumer reporting agency listed in this letter.

Name: Temporary Account Number: CVC/CVV: Expires On: Temporary Credit Limit: $0 Please sign here:

This temporary card is not valid until signed.

You may use your Temporary Shopping Pass as if it were your actual credit card with the following restrictions - once any of the limitations below are met, your temporary account number will no longer be valid for use:

You may use this Temporary Shopping Pass for up to
A single transaction cannot exceed $0.00
You may use the Temporary Shopping Pass for up to 0 transactions

Scan this barcode to use the customer's new Alphaeon Credit Card account as payment.

Name on Card: Account Number: Credit Limit: $0

Alphaeon Credit Account Application

Step 1: Application

Cardmember Benefits:

Your Personal Information

Contact Information

The Alphaeon Credit Card account

Reward Terms and Conditions

Important Information About Your Credit Report.

Your Temporary Account

Know how to use your temporary account

Welcome Offer

Scan Barcode as Payment