Home
About Orchard Anesthesia
For Patients
For Providers
Bill Pay
Home
About Orchard Anesthesia
For Patients
For Providers
Bill Pay
Contact us
Patient Payment
Payment form
Who is Making Payment
(Required)
I am the patient making payment
I am the facility making payment on behalf of the patient
I am the surgeon’s office making payment on behalf of the patient
Information Needed
Patient first name
(Required)
Patient last name
(Required)
Patient date of birth
(Required)
MM slash DD slash YYYY
Patient email address
(Required)
Patient phone number
(Required)
Date of surgery
(Required)
MM slash DD slash YYYY
Last name of surgeon
(Required)
Location of surgery
(Required)
Eye Care of San Diego
Inland Valley Surgery Center
Scripps Mercy Surgery Pavilion
San Diego Outpatient Surgery Center
Mission Valley Heights Surgery Center
San Diego Endoscopy Center
North Coast Surgery Center
Golden Triangle Surgery Center
Surgery Center of California (California Retina Associates)
Other
Name of the surgery center
Payer Name
(Required)
Payer email address
(Required)
Payer phone
(Required)
Price
(Required)
Payment Details
(Required)
Home
About Orchard Anesthesia
For Patients
For Providers
Bill Pay
Home
About Orchard Anesthesia
For Patients
For Providers
Bill Pay
Contact us
