Welcome to Veloce Solutions!

Let's get you started with Merchant Processing!
Fill out this form to make sure we have the correct information on file for you.

*Remember to put the clinic/provider information and do not use a staff member's info. Thank you!

First Name *

Last Name *

Friendly Business Name *

Legal Business Name *

BusinessType *

TaxID/EIN Number *

Office Email *

Phone - Voice *

Phone - Texting

Office Address *

City *

State *

Zip code *

Office Timezone *

Website *

Credit Card Processor - Company Name *

Credit Card Processor - Contact Name *

Credit Card Processor - Contact Phone # *

Credit Card Processor - Contact Email

We do not like to collect Bank information online. Please contact Veloce at 614-660-5650 to securely provide banking information for your new gateway.

Additional Notes

info@velocesolutions.net

(614) 660-5650