Patient Portal Payment

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We’ve created this secure payment portal to provide an easy way for friends and family to support their loved ones during treatment. You can use it to add funds to a patient’s account for items such as store purchases or medication costs. Once your payment is processed, our team will be notified, and the funds will be applied directly to the patient’s account.

If you were informed of any treatment-related costs prior to admission, this portal also offers a convenient way to make those payments.

Please note: Any reimbursement of patient funds will be issued directly to the patient via check.

If you have any questions or need assistance, don’t hesitate to reach out—we’re here to help!

Patient Name:(Required)

First Name Last Name

Your Phone:

Your Email Address (for receipt):

Amount Submitting:(Required)

Credit Card Number:

Card Expiration Date

Card CVV

Card Holder Name

Zip Code

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Patient Portal Payment

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