With a Patient Notebook account, you can directly contact your doctor, view your healthcare records, and easily pay your medical bills – quickly, privately and securely – all from the comfort of your computer.
Centria Autism
27777 Inkster Rd.
Farmington, MI 48336
(248) 436 - 4592
Client Information
First Name *
M.I.
Child Receiving Treatment
Last Name *
Invoice Number *
For Multiple Invoice Numbers, Separate with a Comma.
Medical Record Number
Letter and Numerical Code Listed Under the Name on the Statement. Type letters and numbers only
Patient Date of Birth *
Cell Phone Number *
Email Address *
A receipt will be sent to this email address.
Payment Information
Make A Payment
Amount is required.
Installment Amount must be equal to or greater than the Minimum Installment Amount shown.
Installment Amount exceeds the Plan Balance.
You cannot set up a payment plan without submitting a valid email address.
First Payment Date is required.
Payment plans must start today or later.
Payment plans must start within one year.
First Payment Date is invalid.
How would you like to pay?
One-time Payment
Choose a Payment Method
+ Bank Account
+ Credit/Debit Card
Bank Account
Change
Credit/Debit Card
Change
Centria Autism
27777 Inkster Rd.
Farmington, MI 48336
Copyright 2014 Waystar. All rights reserved. Established in the United States. Patient Notebook.