Payment

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

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.

  • Fill out the form below to submit a payment.  Fields marked "*" are required to submit payment. Questions?  Click here to contact us.  After payment, you will receive an email copy of your information submitted.
  • Please enter a numbers only, with 2 decimals. Example: 100.00
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