CLS Health Payment Portal

Pay Statement Online

Use the information from your mailed statement to accurately fill in the necessary details for payment on our secure payment portal.
Patient Name*

First NameLast Name
Office ID*
This will be under the "Make Checks Payable To" section of the statement
Invoice Number / Chart Number*

Payment Amount*

USDDescription

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Pay Statement Online