MAKE A PAYMENT Use the form here to submit a payment securely online. You may also call our office to make a payment by credit card over the phone. Basic Info Payment Confirm Basic Info Personal Information Invoice Number * Patient First Name * Patient Last Name * First Name * Last Name * Email * Next Payment Payment Information Payment Card Terminal Pay Credit Card Add New Card Pay with Terminal I accept the no Previous Pay Now $ USD Payment Successful Thank you! Your payment to Nickel City Physical Therapy has been accepted. Thank you! Page will be redirected in seconds.