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Welcome to the payment processing website for
Landmark Occupational Health
Click "CONTINUE" to begin processing your payment.

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Please enter all the required information:

Name *

*First name

*Last name

File *

*Last 4 Social Security Number (SSN) digits

*Date of service

Bank Account Info *

*Account type

*Credit card number

Exp. month

Exp. year

Bank name

Payment *

*Payment frequency

*Number of payments

NOTE: All recurring payments are automatically deducted on their specified due date. Once you've scheduled the recurring payment you do not have to make any separate payments towards that payment schedule except specifically advised to do so by the company.

*Payment amount (in USD)

*Payment date (mm/dd/yyyy)

Please double check your information:

I hereby understand and agree that:

My full name is firstName lastName.

Social Security Number (SSN): XXX-XX-altFileNumber

Date of service: notes_ServiceDate

I have the authority to make payments from the following account:

Card Number: creditCardNo

I understand that Landmark Occupational Health will deduct $amount from this account on effectiveDate.

I further understand that, unless I call A-Stat at (401) 723-5533 to cancel, a payment of $amount will be deducted from this account frequency starting from effectiveDate.

These payments will continue for a total of totalPayments payments.totalPayments

If you fully understand and agree, please click "I ACCEPT" to submit your payment. If any information is incorrect, return to the "Make a Payment" page by clicking the "EDIT" button below.

I ACCEPT

EDIT