Make a Payment


 

Instructions

Please enter the Patient Name at the bottom of this page and click the “Pay Now” button underneath it. You will be redirected to an outside host called Transaction Express to complete your secure payment. Follow these steps:

  1. Enter the credit card number, expiration date, and name listed on the card.

  2. Under Recurring Information, you will have the option to choose a payment frequency.

    • If this is a one-time transaction, choose Single Payment in the dropdown menu and fill in the following: Number of Payments: 1 / Recurring Start Date: [today’s date] / Recurring Amount: [total payment amount].

    • To set up recurring payments, enter whatever frequency and amount you’d like.

    • Please make sure to enter your payment in this format: 0.00 (with two decimal points)

  3. Check the “I’m not a robot” box to confirm you are a human!

  4. Click the Submit button.

If your payment is successful, you will see a printable receipt from Transaction Express and a “Thank You” confirmation page on our website.

 
 

Patient Name:

Questions? Call (800) 654-9256 for technical assistance with Transaction Express.