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Three Rivers Hospital

Brewster, Washington

Secure Payment Form

     
Account Number
First Name
Last Name
Address
City
State
Zip
Phone Number
Email Address

Required for receipt

Payment Amount
Name on Card
Card Number
Billing Zip
Expiration Date

MM/YYYY

CVV2/CID

3 digit number on back of card

As a convenience to you, we have an online payment option for you to make payments for your medical services without having to use a postal stamp or visit our business office.

Please complete all fields in the Customer Information section on the left side of this page.

Your Patient Number can be found on your bill. By entering your email a receipt of your online payment will be sent to you after your transaction is complete.

Questions about your hospital bill?

Would you like to arrange payment terms?

Are you interested in financial assistance options?

Questions using our online bill pay service?

To speak with a hospital representative please call Patient Financial Services at 509-645-3362.

Monday-Friday, 9:00 AM to 4:00 PM


Privacy Policy: We are committed to protecting your privacy. We only collect information about the transactions you undertake including details of payment card. We will never pass your personal data to anyone else. The security of your personal information is very important to us. When you enter sensitive information (such as a credit card number) we encrypt that information using secure socket layer technology (SSL).