Name

Address

City, State, Zio

Daytime Phone Number

Account number (if available)

Email Address

Best way to contact

Account Balance (if known)

First Payment Amount

Payment arrangement amount


Weekly


Bi-weekly


Monthly

Additional Information

Once submitted, your information will be sent to our billing department.

 

If your payment arrangment is accepted, you will receive an email and/or phone call to confirm your arrangments.

 

Some payment arrangements will require automatic billing of your payment terms. If you have any questions regarding this, you email billing@oakwoodclinical.com

 

 

Home
About Us
Counselors
Groups
Forms
FAQ
Contact Us
HIPAA
Locations
Insurance & Billing
Pay Your Bill Online Now
Make A Payment Arrangement Now
Employment Opportunities
Surveys
Free Screening