Your Details

First Name

Last Name



This phone number will be used for 2 factor authentication (2FA) later to ensure your account is secure.

Post Code

Allows us to contact you at an appropriate time.

We Take Your Privacy Seriously

Before you enter into an agreement with us, you have a duty to disclose any accurate and relevant information regarding your financial circumstances that may affect the service that you are eligible to enter into.

This may include:

  • Personal information
  • Statements for outstanding secured and unsecured debts
  • Relevant financial statements
  • Evidence of Income
  • Proof of Australian residency status

At Revive Financial Group, we are committed to protecting your privacy at all times. We are bound by the Privacy Act 1988 (“the Privacy Act”) that outlines how we collect, hold, use and disclose your personal information.

By visiting our website, having a telephone call with our team members or applying for a service, you agree and consent to your personal information being collected, held, used and disclosed as set out in our Privacy Policy.

We take reasonable precautions to secure your personal information and ensure it is protected against unlawful use, unauthorised access, modification and disclosure.

As part of our services to you, we may provide your personal information that you disclose in this online assessment form to our referral partners. We work with a number of referral partners and when you choose to consider the refinance option we will advise you of the name of the referral partner. We may receive commissions from our referral partners for a referral that we make. You will not be charged any referral fees. If you take-out credit that is regulated by the National Credit Code, your credit contract will usually describe the referral fees and commission that will be paid by the lender in relation to your credit contract.

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Book a call or call us now to discuss your debt solution options with our Customer Success Team.