Patient Notebook

Ascent Walk in Clinic

17100 Silver Parkway, Ste B

Fenton, MI 48430

Phone: (517) 258 - 8022

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

Account Number

Email Address

A receipt will be sent to this email address.

2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel