OrderlyMeds Wellness Spending Account Credit Authorization Form

Authorization Statement

By signing below, I, [Customer Name] provide "written instructions" under the Fair Credit Reporting Act, authorizing OrderlyMeds to obtain information from my personal credit profile from one or more consumer reporting agencies, including but not limited to Equifax, Experian, and TransUnion.

This soft credit inquiry is solely for the purpose of determining my eligibility for prequalification for the OrderlyMeds Wellness Spending Account. I understand that this inquiry will not affect my credit score.

I acknowledge that my information will be securely stored and accessed only by authorized members of the OrderlyMeds credit team. My information will not be shared with parties outside of the OrderlyMeds organization. I further understand that prequalification does not guarantee final approval, which is subject to additional review by the OrderlyMeds team.
​​​​​​​
OrderlyMeds is committed to protecting your personal information. All data collected will be stored securely and used exclusively for the purposes outlined in this authorization.