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Welcome to The Robbins Health Alliance

We are proud to offer you Holistic Medicine

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Pay Now. Save Time.

If you are a private or self pay patient you may pre-pay for your visit. Our current patients can pay their outstanding balance on-line using paypal. This will help you avoid collection fees as you payment will be posted the same day in post cases.

Credit Bureau
If your account has been turned over to the credit bureau a payment may still be made on-line. Your credit report will be updated upon receipt of your payment. Accounts reported to the credit bureau may result in termination from the practice.

On-line Payment - Save time and money by paying your bill on-line today.

Pre-register with our Office

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:

Email Address:
Date of Birth	Must be 21 or older

	Self Pay Patient
Insurance Plan:
Subscriber Number:
Group Number:
Group Name:
Deductible Amount::
Co-payment Amount:
Insurance Billing Address:
Past Medical History:
Reason for visit	Enter comments here! All information is kept confidential Please bring your current medical records to your first appointment. We do not accept Medicare or Medicaid.