Patient Billing Online Bill Pay
PAYMENT PLAN BY CREDIT CARD:

I HEREBY AUTHORIZE MEDcare Urgent Care to initiate charges to my credit card in the amount specified below:

Please allow 3-5 days to process, your confirmation will be emailed to the email address you provide below.

If you would like to cancel your payment plan at any time, please call us at: (843) 576-5246.
Location: *
Date of Service: *
Patient First Name: *
Patient Last Name: *
Account Number: *
Re-enter Account Number: *
 
PAYMENT PLAN INFORMATION:
Select Payment Period:
Amount to be drafted: *
Number of payments: *
OR  
Pay until balance is $0.00:
Credit Card Type:

Credit Card Number: *
Expiration Date: Month: / Year: *
Security Code (CVV): 3 Digits (4 digits for AMEX) *
Cardholder Name: *
Billing Address: *
City: *
State: *
Postal Code: *
Email Address:
Phone Number:
Comments:
 
 
 
 

Your credit card charge will appear on your bill as:

MEDcare Urgent Care