Patient Notebook

Dulles Health & Rehab Center

2978 Centreville Road

Herndon, VA 20171

Phone: (866) 712 - 4810

Email: ccrcollectiondepartment@commonwealth-care.com

Website: dulles-rehab.com

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1. Patient Information

First Name *

M.I.

Last Name *

Enter resident's name

Account Number *

Enter six-digit account number, including leading zeros

Dates of Service

Statement Date

Email Address

A receipt will be sent to this email address.

2. Payment Amount

Amount

Enter payment amount

3. Payment Method

Credit/Debit Card

Bank Account

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel

P (866) 712 - 4810

W dulles-rehab.com

2978 Centreville Road

Herndon, VA 20171