Set up your Pre-payment funding account for your next visit.
This is a simple 2 step process
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.