MedicalPayments.org: Customer Information

Thank you for visiting our website. You have the ability to make payments here via credit card or electronic check. You can either make payment in full or make a partial payment on your balance. Be advised that any monthly payment plans require contacting our office for approval.

To continue please enter your information below:

GUARANTOR INFORMATION:

Last Name:
First Name:

Zip Code:

Account Number:*
*Can be found on the statement or monthly payment coupon on which you want the payment applied.

Do you wish to pay your account in full today?	YesNo
Payment Method:*	Credit Card Electronic Check