Payment Type

LONG TERM CARE PATIENT PAYMENT FORM

This form is to make a payment for a long-term care patient online.
Select the form of payment you would like to use below:

ACH - Requires Paypal Account and will incur a processing fee (3.99%)Credit Card - will incur a processing fee (2.99%)Debit Card, FSA or HSA Card - no processing fee
For additional payment options, you can mail a check to Attn: Good Day Pharmacy, 3780 E. 15th St, Ste 102, Loveland, CO 80538. Alternatively, you may call 970.461.9101 option 5 to set up autopay using ACH, Debit, FSA, or HSA at no additional charge. If you prefer to use a credit card for autopay, please note there will be a processing fee.
Should be Empty:

LONG TERM CARE PATIENT PAYMENT FORM