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Morton Hospital and Medical Center Logo

Online Patient Payment Center

Welcome to Morton Hospital and Medical Center Online Payment Center.
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 during working hours.
* Name of Patient
Name of patient treated.
  Invoice number (optional)
Invoice number. (Should be located on your bill, this is optional.)
* Name of Payor
Payor's name on credit card.
* Billing Address
Address where your credit card statements are mailed.
* City, State, Zip
Please include your city, state, and five digit zip code.
* Your email address
Please provide an e-mail address.
* Amount of your payment
Please specify how much you are paying. Please use dollars and cents.
* Credit card type
Select if you are paying by credit card.
Visa     MasterCard     Discover     American Express    
* Credit card number
Input the 16 digit number just as it appears on the card.
* Credit card expiration date
Example: 00/00
  Comments Or Messages Related To Your Payment