Step 1 - Patient Information

  1. Begin the online payment process by choosing the clinic where you were treated.
  2. Patient Name should be the name of the patient's account for whom the payment is applied.
  3. Account Number is the patient's account number which can be found on the upper left portion of your statement. If you don't have your statement, you can bypass this field.
  4. Enter the $ amount of your payment. Your credit card and billing information will be collected on the next page.
  5. Select the Continue to Make Payment button to advance to the next page.

Step 2 - Checkout

  1. Confirm Your Clinic
  2. First Name and Last Name are required fields
  3. Enter a valid email address so that we can email you a confirmation that your payment request was received
  4. Enter the billing address for your credit card
  5. Enter the City, State, and Zip Code which also matches the billing address for your credit card
  6. If the billing address you enter doesn't match the address on file with your credit card, your payment will not go through
  7. Enter a current phone # so that we can reach you if there are any problems with your payment
  8. Select your Credit Card type from the list of accepted credit cards.
  9. Enter the credit card number exactly as printed on your card.
  10. Select your credit card's expiration month and calendar year
  11. Enter the 3 digit code which is usually found on the back of your credit card.
  12. Verify your payment amount
  13. Select the Submit Payment button to finalize your payment.