Payment Form

Please enter information on this form to make a payment.

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Email *

Phone *

Address *

City *

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Zip *

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Major Credit Card

Total Amount

Payment method

Stripe

Billing Zipcode*

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Hours of Operation for All Clinics:
Mo-Th 8:00 AM – 5:00 PM
Fr 8:00 AM – 4:00 PM

Our Clinic Locations