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724-285-4225

Set up your Pre-payment funding account for your next visit.

This is a simple 2 step process

If you are interested in signing up for a pre-payment account, please fill out this form and a representative from our clinic who is familiar with this program will contact you or you can just sign up now online without needing to talk with anyone. Any unused funds can be refunded at any time just with a simple phone call or email.
You may call our manager at any time and leave a message. He will routinely return calls within 24 hours. His number is 724-242-8222.  You only need to complete step 2 if you want to make sure your card is on file with us now.

 

STEP 1 – Fill out this form

 

STEP 2 – Make your first payment

You only have to complete this step if the card you want to use has not been used at the clinic within the last year.  If you are not sure, you can just complete the 2nd step as it will only charge your card $1.00 now which will go on your account and to verify your card information.  The information asked in the next page will go directly to PayJunction.  Your card number will not be kept at our clinic and only the last 4 digits are available for us to see even through their dashboard.  Your name and address will be used to verify we have the correct account and the email address will enable PayJunction to send you a receipt then they charge your account.