Dr Clark Payments

Please complete the below form, select the payment(s) you want to make and click on Submit & Pay.
The secure Authorize.net payment window will appear and you can complete payment.

 

Name *
Email *
Date of appointment
Select Payment/s*
Appointment Payment 20
Appointment Payment 100
Appointment Payment 200
Appointment Payment 250
Book Payment 15
Book Payment 25
Book Payment 30
Total
$ 0.00
Submit & Pay