Make a Payment
Please use the button below to make a payment towards your account. You will be redirected to our secure payment center, Navicure, where your payment will be processed. Your Payment ID can be found on your monthly statement, sent either through the mail or via email, with your permission. If you would like to set up emailed statements, please call our office at 312-640-7740.
If you have not already scheduled an appointment, please contact our intake coordinator at 312-640-7743 to discuss scheduling an appointment with one of our clinicians. There is no need to fill out these forms until you have already scheduled an appointment with us.
Follow these steps to fill out the form:
1. Download the PDF. For the best experience, use a desktop device.
2. Open the PDF and fill out the appropriate entries.
3. Save the form and email it to firstname.lastname@example.org.