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El Campo Memorial Hospital

Clinic Patient Payment Center

Welcome to the Clinic Payment Center. You may pay your clinic bills here by credit/debit card.
For your convenience please fill out the payment form below. All information will be kept secure and confidential. For more information you may call our business office at 979-578-5142 - Monday through Friday 8:00am - 4:30pm

You may make payments to El Campo Memorial Hospital by submitting your credit card information in the below fields.

All payments are via secure server. Thank you for allowing us to serve you.
* Patient First Name
First Name of Patient Treated.
* Patient Last Name
Last Name of Patient Treated.
* Patient Account Number
Account Number. (Should Be Located On Your Bill beginning with "4")
  Comments Or Messages Related To Your Payment. If you would like to pay on more than one account, please list the account number and amount to be applied to each.
Billing Information
* Credit Card Type
* Cardholder First Name
The first name of the account holder as it appears on the credit card.
* Cardholder Last Name
The last name of the account holder as it appears on the credit card.
* Amount of Payment
Format: 45.67 (Include decimal and cents. Do not use a dollar sign.)
$
* Card Number
* Expiration Date
* Card Code Verification Number
The three digit number on the back of your card. (Four digit code on the front of American Express.)
* Billing Postal or Street Address
* Billing City
* Billing State
* Billing Zip Code
5 digit zip code