Bill Payment

Patients may use the bill payment form below to remit payments for Westside Gastroenterology Associates and Westside Endoscopy Center.

Credit Cards Accepted:

Secured Site:

Be assured that we have maximized your security and privacy by using SSL (Secure Socket Layer) to encrypt all of the information you enter into the "Online Bill-Pay" form. The lock symbol at the bottom corner of your browser's status bar confirms that your information will be encrypted and secure during transmission.

For additional security, we do not store your credit card information. We process all of our online payments through Authorize.net payment gateway services .

Patient Account Information

Patient Name:
Patient Account:
Date of Birth:
Telephone Number:
Email Address:
Comments:

Credit Card Information

First Name:
Last Name:
Street Address:
City:
State:
Zip Code:


Credit Card Type:
Credit Card Number:
Expiration Date:	/ (MM/YY)
Credit Card CCV:	(3 or 4 digit security code)
Payment Amount:

Westside Gastroenterology Associates - Gastroenterology Internal Medicine

Bill Payment

Credit Cards Accepted:

Secured Site:

Secure Patient Portal

Endoscopy
Center

Procedure
Prep

Bill Payment

Credit Cards Accepted:

Secured Site:

Secure Patient Portal

EndoscopyCenter

ProcedurePrep

Endoscopy
Center

Procedure
Prep