Payment Type

LONG TERM CARE PATIENT PAYMENT FORM

This form is to make a payment for a long-term care patient online.
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 4 to set up autopay using ACH at no additional charge.
Should be Empty:

LONG TERM CARE PATIENT PAYMENT FORM