Pay My Bill

For your convenience, you may use this secure form to pay your Legacy Behavioral Health Services bill online.

Patient Client Information

Client ID

Client Name

Client DOB

Payment Info

Payment details

Card Number

Expiration Date

Security Code (CVV)

MasterCard

Amount

$

Billing Info

Company Name

First Name

Last Name

Address 1

Address 2

City

State

Zip/Postal Code

Country

Email Address

Phone #

Click here to make a payment