Make a Payment – MedScreens, Inc

Simple • Secure • Convenient

Make a Secure Payment to MedScreens

Use the form below to submit a payment for an invoice, account or testing service. You will enter your payment method securely during the checkout step.

Enter Payment Details

Tell us who the payment is for and enter the amount you wish to pay.

Add Your Information

Include the invoice or account number when available so we can apply it correctly.

Proceed to Checkout

Review the information, sign the form and continue to the secure payment step.

Before You Begin

Have the company or donor name, payment amount and invoice or account number available. Fields marked with an asterisk are required. If you are unsure what information to enter, call MedScreens at 601-939-3030.

Payment Details:
Date*

Please input the date the payment is being made.
Company or Donor*
Please input the company or donor that this payment is being made for.
Payment Amount:*

Input the total amount you desire to pay during this transaction.
Invoice Number (if applicable)
Input any or all invoices this payment is to be applied to.
Account Number: (if applicable)
Input the account or case number.
Note:
Please list any special instructions or additional notes you would like to include about the payment above.
Authorizing Individual:
Name*
First Last
Email
Billing Address:
Street Address Address Line 2 City State ZIP Code
Total
$0.00
Authorized Signature*
Your Name
Your Name
Your Name

Need Help With Your Payment?

Call our office Monday through Friday from 8:00 AM to 5:00 PM and we will be glad to assist you.

CALL 601-939-3030