You will need the following information to process your payment:

Clients:

Your Name & Month of Invoice  (MMYY format)

Patients: 

Patient's Name, Name of Your Provider or Facility, Date of Service (MMDDYY format), and or Ticket# from invoice.


We Accept The Following Major Credit Cards:

To begin the payment process, enter the payment amount below and click submit:

All fields are required. Please insert "N/A" for fields that do not apply!

If you're making your payment using a mobile device, please scroll horizontally to view the entire form. 

ALL RECEIPTS ARE SENT VIA EMAIL. PLEASE CHECK YOUR SPAM & JUNK MAIL FOLDERS.


Client Name/Month of Invoice:
Patient Name/Provider Name:
Date of Service (MMDDYY) or Ticket#:
Amount: