Pay My Bill

Please use the form below to make a payment. If you would like to speak with someone about your bill, please call (855) 347-3685 between 7:30pm to 5:30pm CST, Monday-Friday. If you would like to speak with a representative, please visit our location page for contact information.

  • Patient Information

  • Billing Address

  • Payment Information

  • This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.
    American Express
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  • $0.00