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To make a payment with your credit card, just fill out the amount below and click 'Make a Payment'. You'll be taken to PayPal's Website, where you can complete the payment to me safely and securely.


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If you do not wish to use PayPal please include the Credit Card number, expiration date, Zip Code number on your Credit Card account and the amount to be charged in the form below. *All information submitted through this form is confidential

We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.


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