Make a Payment

To make a payment online, please enter the patient's name and follow the paypal link below. You can either sign in to your paypal account, or click on guest to use a credit or debit card.

*HSA Cards are typically able to be processed using the link below, however there are occasional issues. If you are experiencing issues please call us at 715-977-2441.

Request a Payment Plan

Payment Plan Request

Patient Name

First Name

Last Name

Desired Date to Begin Payments

YYYY

Requested Payment Amount

Requested Frequency of Payments

Name on Card

First Name

Last Name

Card Number

Expiration Date

YYYY

CVV

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Information