Pay My Bill

Make an Appointment

Use our secure form to pay your bill online. If you have any questions or concerns about your bill, you can contact our Patient Financial Services.

National Jewish Health believes in providing access to care for all patients, including those of limited means. View our Financial Assistance Policy.

Patient Information

First Name*

Last Name*

Patient Account Numbers

Medical Record Number

Email*

Address 1*

Address 2

Country

City*

State*

ZIP* (99999 or 9999-9999)

Home/Mobile Number*

Work Number

Amount* (9.99)

Payment Type

Credit Card
Electronic Check

Billing Information

Same as Patient Information

First Name*

Last Name*

Business Name

Address 1*

Address 2

Country*

City*

State*

ZIP* (99999 or 9999-9999)

Credit Card Info

Card Type*

Card Number*

CVV2*

Expiration Month*

Expiration Year*

Electronic Check

By marking this checkbox, I am authorizing the entered bank account to be charged for the payment amount entered. As payor, I am authorized to conduct transactions from the entered bank account and all information entered is valid.

Routing Number*

Account Number*

Account Type* Checking
Business Checking
Saving

Bank Name*

Name on Account*