Payment Options
We offer multiple payment methods. Please review the options below and select your preferred payment method prior to your initial evaluation.
Patient Name
*
First Name
Last Name
Invoices & Receipts can be sent to this email
*
example@example.com
Date
*
-
Month
-
Day
Year
Date
Invoice Frequency
*
Please Select
Week of Appointment
Beginning of Month
Pay Upfront (Required for Package Deals)
Please select one option in the dropdown menu
Select how you will pay for physical therapy services
*
Credit, Debit or HSA Card - A secure payment link will be emailed to you (3% processing fee applies)
Mail check to Mizuta & Associates Physical Therapy 8281 Polizzi Place San Diego, CA 92123 (No fee)
Venmo - Send to @Ericka-Mizuta (No fee)
Google Pay/Apple Pay - Available upon request (3% processing fee applies)
ACH Bank Transfer - Secure bank transfer available upon request
Zelle - Send to emizuta@mizutapt.com (No fee)
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