Make a Payment

Submit your payment

This payment form is secure

Name*
Your account number with Cayuga Dermatology
Billing Address*
The billing address associated with your card
This email address will receive a receipt
Type in your payment amount
Credit Card*
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
 
This is the total amount that will be charged
This field is for validation purposes and should be left unchanged.
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