Raleigh Capitol Ear, Nose & Throat

Secure On-Line Payment

Personal and Credit Card information is safe with our secure server and PGP software, a superior encryption algorithm (1024 bit) for e-mail.

For payment towards your balance, please enter the amount in the box below.

Patient Name

Account Number

Amount

First Name

Last Name

Address

City

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Card Number

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Email

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Please print a copy of your transaction receipt once you have completed your online payment.