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Emergency Medical Services (EMS)
Online Bill Payment – Ambulance Service

Online Bill Payment – Ambulance Service

ONLINE BILL PAYMENT

Please have a copy of your bill to fill out all information below. Please note the areas circled in red below.

Should you have any questions, please call 706-278-9211. A receipt will be emailed to you for your records.

**Please Note: This is for Ambulance Service payments only.

AMBULANCE SERVICE BILL PAYMENT

We are located in Dalton, GA

Name as it appears on card * Required
First Last
Billing Address * Required
Street Address Address Line 2 City State ZIP Code
Email * Required
Phone * Required
Patient ID * Required
Patient Name: * Required
First Last
Ticket #
Desired Payment Amount * Required
Credit Card * Required

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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