Credit Card Information Please note that we do not accept AMEX.Email* Is this an HSA/FSA/Flex Spending Account? Yes No Patient's Full Name* First Last Patient's Date of Birth Full name as it appears on the card* Credit Card Number except the last 4 digits* Last 4 digits of Credit Card Number* Expiration Date* CVV* Billing Zip Code* Signer's Name* First Last Please type in the name of the patient or the guardian, if patient is under 18 years of age, to sign the document. Recent News Spring Past Your InjurySpring is here, and with it comes the excitement of marathon season. […] COVID Long HaulersThere is a subset of individuals who experience prolonged symptoms of COVID-19 for weeks, if not months, despite having survived the initial infection. These individuals have dubbed themselves COVID Long Haulers or those living with long COVID. […] Back to School: How to Prevent Sports InjuriesComing back to a new school year for some may not only mean returning to […] PatientsNew Patients New Patient Registration Missed Appointments Insurance We Accept Billing Policies Insurance Resources Pay Online Medical Records Release POST PT Telehealth Appointments