Patient Notebook

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.

Patient Information

First Name *

M.I.

Last Name *

Account 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

Amount *

Choose a Payment Method

+ Credit/Debit Card

Credit/Debit Card

Change

Name on Card

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel