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With the help of our new online terminal, you can now make a secure payment toward your medical services with the click of a button. Enter the information into the fields below, click the Make Payment button and the transaction is complete. You will receive a payment receipt from Pontiac Trail Medical Center within 5 to 7 days of this transaction.

Note that ALL fields are required.

First Name Middle Name   Last Name
 
     
Patient ID   Birthday
 
     
Home Address   City
 
     
State Zip   Email
 
     
Home Phone   Work Phone
 
     
Credit Information
The credit account used in this transaction must match the information entered above.
     
Card Number Card Type   Expiration
 
     
Please refer to the last billing statement that you received from PTMC and choose the amount that you would like to pay toward your account balance on this transaction.  
Amount to be Paid

$

     

 
 

 

 
 
 
 
  Site by: PIXELBIT