Payments « PL Medical

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Checks by Mail

Checks should be mailed to:

PL Medical Co., LLC
321 Ellis Street
New Britain, CT 06051

Please remember to include your invoice number on your check.

Credit Card Form by Fax

Download and Fax the Credit Card Authorization Form
(860) 223-5941

Upon processing a receipt will be faxed to the number indicated on the sheet.

Credit Card Form Online

Billing Information
	* Required Fields
* First Name:
* Last Name:
Business Name:
* Email:
* Telephone:
Billing Address 1:
Billing Address 2:
City:
State:
* Billing Zip Code:
Country:

Payment Information


* Card Type:
* Card Number:
* Expiration Date:
* CV2 Number:	What's this?
* Bill my credit card once for the following amount:
* Please apply this payment to the following Invoice: