All information entered below should be as it appears on your last statement. Accounts that have a balance of $0.00 are not currently available online.

(This site works best in current versions of Google Chrome or Mozilla Firefox web browsers. If using Internet Explorer 10/11 you may need to add this site to the Internet Explorer compatibility view list.)

*Fields are Required
Patient Information
*Patient First Name:
*Patient Last Name:
*Patient Date of Birth: (mm/dd/yy)
Visit Information

**Account Number:

Please read the instructions to the right for entering your account number correctly.

** XXXX-XXXXXXX (Only include the characters after the hyphen on your statement)

Example - If your account number is listed on your statement as 5570-V123456789, enter only the V123456789 as the Account Number. Also, be sure to include all of the characters in the account number after the hyphen, including any leading zeroes.

Email Information
Email Address:
Email Confirm:
  I have read the "Notice of Privacy Practices" and agree to the use and disclosure of information as stated in the document.
  Having trouble logging on, or have other questions? Please call us at 1-877-444-6382.