Make a payment

#mainContentWithJavascript { display:none; }

Javascript is disabled

It looks like you have disabled javascript. This could be due to an add-on you are using, such as NoScript or Ghostery. In order to use this website, you need to enable javascript.

Choose a Payment Method

Account Information

Account number

Memo

Payment Information

First name

Last name

Card number

Expiration date

Security code

Address 1

Address 2

City

State

Country

Zip

Zip plus 4

Email address

Phone number

Payment ($)

You are agreeing to pay $ plus a Fee of $ (%) for a Total of $.

Number of Payments: 0

Confirmation

Are you human?

I authorize Orleans Community Health to process the above payment of $. I also authorize Orleans Community Health to store this information in compliance with payment processing regulations and to charge the card listed above for future payments in accordance with their terms. I understand that to make any changes to this authorization I must contact Orleans Community Health prior to the payment date.

I authorize Orleans Community Health to process the payments as outlined in the payment schedule. I also authorize Orleans Community Health to store this information in compliance with payment processing regulations and to charge the card above for future payments in accordance with their terms. I understand that to make any changes to this authorization I must contact Orleans Community Health prior to the payment date.

Please include your Medina Memorial patient account number when submitting your payment.

If you have any questions please contact our office at 585-798-8401. Thank you for using our online convenient payment center.

Required fields