Patient Payments

PrimeCare of Michigan

Full Name*
First Name Last Name
Date of Birth
MM slash DD slash YYYY
E-mail*
Address*
Street City State ZIP Code
Message
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Payment Info.
Account #*
Amount*

Enter your amount you want to pay
Which location should we apply your payment?*
Please make sure your payment is applied to the right practice. If you have a bill from more than one of our locations please make individual payments for each practice.

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