To pay for a visit you may input the amount owed from any statement or copay.

Additionally, all missed appointments not canceled 24 hours prior to the scheduled time are subject to a $50.00 fee. New patient appointments that are missed will not be rescheduled without payment. Scheduling of an appointment constitutes agreement to these terms. Each appointment time is reserved specifically for each client. Thank you.

Cardholder Information
* Cardholder First Name
* Cardholder Last Name
* Cardholder Phone Number
* Cardholder Email
* Cardholder Billing Address
* Cardholder Billing Zip
Patient ID * if paying a bill this is listed on the bill
Amount $
* Required Fields