Payment Page

PLEASE NOTE:

The CardPointe HPP now uses reCAPTCHAv3 to authenticate your customer's payment attempts. reCAPTCHAv3 uses enhanced risk analytics to validate the authenticity of your users while they interact with the payment form. As a result of this enhancement, some merchants have reported an increase in incomplete payments due to false positive reCAPTCHA fraud detection.

To avoid decline errors due to reCAPTCHAv3:

DO NOT USE auto-fill when completing your payment form
DO NOT USE the tab key or the arrow keys to navigate the page

Clinician/License

Patient Name

Patient Date of Birth

Total Amount Due:

Password

Remember Me

Create Account / Forgot Password?

Payment Info

Payment details

Card Number

Expiration Date

Security Code (CVV)

Billing Info

First Name

Last Name

Address 1

Address 2

City

State

Zip/Postal Code

Country

Email Address

Phone #

lock Payment Page

Payment Info

Payment details

Billing Info

Payment Page