Payment is due at the time services are performed. For your convenience we accept cash, checks, Visa, MasterCard, and American Express. We offer to automatically charge your card and send a statement for your records. If you would like to have your credit card information kept on file, please print this document and provide the required information (click the download button at the bottom of the page). You may mail the completed form to the address below or give to the Doctor at your visit.