Online Payment

Use this form to make payments for:



  • Your upcoming surgery

  • Scheduling deposit

  • Your existing payment plan


Paypal Payment for specific amounts:


You will receive a separate email with link for payment in PayPal.

Payment Form
(mm/dd/yyyy)
For the exact amount due, contact us via email or call us at (301) 654-7070


Sending

Important Notes


Payment for upcoming surgery:

  • You may make online payment for your upcoming surgery or visit. Please speak to our treatment coordinator about the exact fees.

  • Your payment will be credited to your account. On the day of surgery, your payment will be posted towards services provided.

  • Your payment is fully refundable if surgery is canceled for any reason. If you have an existing balance from prior visits, it will be deducted from your payment.


Scheduling deposit:

  • The scheduling deposit is $500.00 for surgeries which will be credited toward services. This will confirm your reservation for the given appointment.

  • There will be a $25 charge for any cancellations made on the day of appointment.

  • There will be a $50 charge if you fail to keep your appointment with no prior notification.


Payment for existing accounts (payment plans):

  • Please refer to your agreement for the exact amount of your monthly payment.


Payment for second opinion:

  • The fee for obtaining online second opinions is $175.00

  • Please click here for instructions on how to send records.