Online Payment | Genesee Valley Physical Therapy

Our Physical Therapists and clinics are adhering to strict CDC guidelines and remain open to those in need of treatment.
We are now offering appointments by phone and video chat covered by insurance.

ONLINE PAYMENTS

MAKE AN ONLINE PAYMENT

DO NOT USE FOR ROCKSTEADY BOXING

PATIENT INFORMATION
PATIENT NAME
PATIENT DOB
BILLING INFORMATION
FIRST NAME
LAST NAME
STREET ADDRESS
APT/BLDG/FLOOR
CITY
STATE/REGION
ZIP CODE
COUNTRY
YOUR EMAIL ADDRESS
PHONE
PAYMENT INFORMATION
We accept Master Card, Visa, Discover and American Express

AMOUNT $
INVOICE #
CREDIT CARD NUMBER
CVV CODE

EXP MONTH
EXP YEAR

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