Do you direct all of your patients to apply at home? If so, you can opt out of receiving paper disclosures going forward. Please fill out the following form, and ALPHAEON CREDIT will no longer send you paper disclosure forms.

Practice Name

Store Number

Your store number can be found on the upper right hand corner of your Comenity Business Center login page

Contact Name

First Name

Last Name

Contact Email

Confirmation

I confirm that my practice does not perform applications in the office and all patients apply from home.