WelcomePay Online Collection AssignmentContact Us

Collection Assignment

If you don’t have a current collection agreement with our office please contact us before assigning accounts. If you are an established client fill out our quick form below to refer your accounts for collections.

 

Last Name
Home Phone
 Work Phone
Spouse Name
 Spouse Social Security #
Date of Last Charge or Service
Amount Assigned for Collection
Client
Client Contact
Client Phone