LOS - Arogya Finance

Personal Information

First name

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Middle name (optional)

Last name

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Father's full name

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Mobile number

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Please enter valid email address

Nature of income

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Name of firm

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Official Email

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**The official email ID is not intended for communication purposes but only for verification purposes.

I accept the following declaration:

Please accept the declaration

By submitting this application, I hereby declare all information provided by me is true to the best of my knowledge and belief. I give my consent to Arogya Finance to receive my bureau details and other financial / KYC details for Healthcare / Wellness / other financing purposes only.

Please note that sensitive information such as ITR credentials is not stored on Arogya Finance servers and is only used for information retrieval purposes.

By submitting this application, I hereby confirm that I fully understand the Installment Plan program and I hereby declare that Arogya Finance may disburse the loan amount into the hospital / healthcare provider's bank account.

To complete evaluation of the application, I hereby authorize the capture of digital selfie using the camera, access my location, run credit bureau report/s. I also give consent to share such data to third party service providers for credit evaluation and other processes required for financial evaluation of the applicantion.