EB2Gov POS

NOTE: There are additional vendor processing convenience fees when making a payment online. These fees are non-refundable.

Please enter your Invoice Number in the following format: ITGT######

HSA/FSA cards are not accepted for payment at this time.

NOTE: There are additional vendor processing convenience fees when making a payment online. These fees are non-refundable.

Please enter your Invoice Number in the following format: ITGT######

HSA/FSA cards are not accepted for payment at this time.

Ambulance Billing

Patient's Last Name:

Date of Service:

Invoice Number:

Amount:

EB2Gov Fee:

Quantity:

Payment Amount:

Notes: