Make a Payment

You can use this portal to make payments on existing statements or to submit payment on your account for future services. After entering your name and payment amount below, you will be redirected to our secure payment page, where you will be asked to complete a simple form to submit payment. We ask that you complete the requested information, including a valid e-mail address and daytime contact phone number.

NOTICE: By selecting this link, you will be leaving conceptionsrepro.com and entering a website hosted by PayJunction.com. Although Conceptions has approved payjunction.com as a reliable partner site, please be advised that you will no longer be subject to the privacy and security policies of Conceptions' website.

Please note that Conceptions is no longer accepting AMEX and Discover. If you try and submit payment with AMEX or Discover, it will be declined. Please use another form of payment.

There was an issue submitting your information, please double-check the information below:

PATIENT INFORMATION

Patient First Name:

Patient Last Name:

Patient Date of Birth:

Patient Account #:

Patient Billing Address:

City:

State:

Zip:

Patient Phone Number:

Patient Email:

CARD HOLDER INFORMATION

SAME AS PATIENT

Card Holder First Name:

Card Holder Last Name:

Card Holder Billing Address:

City:

State:

Zip:

Card Holder Phone Number:

Card Holder Email:

REASON FOR PAYMENT

Payment on Account Balance

Pre Payment

Other

*A 2 percent convenience fee will be added

Enter Amount:

Make a Payment

PATIENT INFORMATION

CARD HOLDER INFORMATION

REASON FOR PAYMENT

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