Payment

You are here: Home > Payment

To speak with a billing representative, contact us at 419-630-2149 or billing@parkview.com.

Pay Online

Fill out the form below to submit a payment. Fields marked with an asterisk are required. After payment, you will receive an email copy of your submitted information.

Questions? Click here to contact us.

Visit ID*

Need help finding your Visit ID? Click here to see where your Visit ID is shown on your billing statement.
First Name*
Last Name*
Billing Address*
City
State
Zip Code
Telephone number where you can be contacted.*
Phone (Work)
Email
Enter Email Confirm Email
- I authorize contact using this email account concerning payments.
Amount to Pay*

Please enter a numbers only, with 2 decimals. Example: 100.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
This is a secure transaction entrusted with Authorize.net
CAPTCHA

Parkview Archbold

Parkview Bryan Hospital

Parkview Montpelier Hospital

Payment

Parkview Archbold

Parkview Bryan Hospital

Parkview Montpelier Hospital

Payment

CHWChospital.org is moving!