Welcome to FX Physical Therapy's Online Bill Pay!
Please have your invoice number handy before you begin..
Name
*
First Name
Last Name
Email
*
example@example.com
Invoice / Statement Number
*
Today's Payment Amount
*
Enter the amount you want to pay towards your statement
Total Due
*
*automatic addition of a 3% online processing fee
Total Due
prev
next
( X )
USD
Today's payment plus a 3% processing fee
Credit Card
Submit
Should be Empty: