PAYMENTS

Your Financial Contributions And Gifts Support Vision And Hearing Services To Those In Need Throughout Georgia

Hearing aid payment

Thank you for visiting the online payment page for hearing clients. Please complete all fields.
For “Address” use the address associated with the credit card being used for the payment

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Payment made on behalf of*
- Myself
- Another Person
Patients Name:*
First Last
Payment amount $*
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

vision payment

Thank you for visiting the online payment page for vision clients. Please complete all fields.
For “Address” use the address associated with the credit card being used for the payment.

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Payment made on behalf of*
- Myself
- Another Person
Patients Name:*
First Last
Payment amount $*
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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PAYMENTS

Your Financial Contributions And Gifts Support Vision And Hearing Services To Those In Need Throughout Georgia

Hearing aid payment

vision payment

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