Pay Your Bill

Required fields are indicated in bold.

1. Indicate Bill To Pay

Patient Name on Account Patient Date of Birth
(Format: MM/DD/YYYY) Invoice Number Amount to Pay Your Email

2. Agree to Our Terms of Use

Using this system to pay your bill is limited to current patients only. Use of this system by persons who are not currently patients of Covenant Pediatrics, who do not have a current accounts with us, or have let their account go into collections should call into the office to handle their payment.

I agree to the terms of use above.

NOTE: We use PayPal to collect payments.

After you hit continue, we will save your information and then you will be sent to PayPal to make your payment. We will prefill this information for you to make it easier. You do not have to be a member of PayPal to use this system.