Pay Your Bill Online

Welcome to Chiro-Medical Group's Secure Online Payment Page

You can now pay your balance due online. Your payment will be applied to your balance within two business days.

Fields marked with an asterisk (*) are required.

Patient name *

Account number

You can locate your account number underneath your name on your monthly statement that you received in the mail. If you are unable to locate your account number, or do not have your monthly statement, you can still make your payment without entering the account number.

Billing information

First name *

Last name *

Address *

City *

State *

ZIP *

Email *

Phone number *

Select payment type *

Visa

Mastercard

Credit card number *

Expiration date *

Month

Day

Year

CVV/security code *

Turn your card over and look at the signature box. You should see either the entire 16-digit credit card number or just the last four digits followed by a special 3-digit code. This 3-digit code is your CVV number / Card Security Code.

Payment amount * $