FHP – Secure Online Payment

Pay Online

Step 1 of 2: Payment Information

Securely pay online using most major Debit Cards and Credit Cards. There are no additional fees for online payments.

Note: This payment page is only for FHP Health Center. Please do not pay TakeCare Insurance using this page.

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Get Started! Choose for what you would like to pay in Step 1 (this page) and check-out with your Debit Card or Credit Card in Step 2 (next page).

Payer's Information

* Means Required Fields

Paying for: *

First Name *

Last Name *

Account Number *:

Account number I don't know it

Enter Account Number *

Best Contact Number(s) *

Area Code * - Phone Number *

+ Enter Another Contact Number

Email Address *

Enter Email Address Again *

Charge Details

SBU's *

Date of Service

Add comments about your payment

$ Amount *

Minimum online Payment is $2.00.

Balance on Account

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Click to UNSELECT this option

Add comments about your payment

$ Amount *

Minimum online Payment is $2.00.

Other

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Describe for what you are making payment *

$ Amount *

Minimum online Payment is $2.00.

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