Welcome to PAL Health's Online Credit Card Bill Pay
Please have your account, invoice, and/or statement numbers handy before you begin..
Name
*
First Name
Last Name
Name on PAL Account
*
Phone Number
*
PAL Customer ID (Account Number)
*
Email
*
Please Provide the Invoice Numbers or Statement Dates You Are Applying Payments To
*
Invoice Number / Statement Date
1
2
3
4
5
6
7
8
9
10
Please Enter Your Payment Amount
*
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( X )
USD
Credit Card Details (Please note: At this time we do not accept American Express)
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: