Make a Payment

Please fill in all of the information below and click the Submit Payment button to process your payment. We use a secure connection to protect your confidential information and we do not save or store any of your credit card information. If you have any questions, please contact us at 801-224-0222.

Payment Billing Information

Patient Name*

Address

City

ZIP CODE

Email Address*

Phone Number

Chart Number

Payment Information

Card Number*

Expiration Date*

Card Holder Name*

Payment Amount*


Request an Appointment


[recaptcha]

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Start typing and press Enter to search