Patient Payment

Make a Payment with a Credit Card or a Debit Card

If you have any questions about your bill or wish to update your insurance, contact us by calling 919-537-3939 or email us at SOD_DFP_payments@unc.edu.

Frequently Asked Questions

Privacy Policy is available at School of Dentistry Website Privacy and Security Policy.


                 


Patient Statement Example




Instructions: Please provide the following information as found on your patient statement (see the above example) to ensure that your payment is properly credited:

Payment Information

* Required Fields

Patient First Name (Must match first name on statement):*
Nombre del Paciente (Debe ser el mismo nombre que en el estado de cuenta):

Patient Last Name (Must match last name on statement): *
Apellido del Paciente (Debe ser el mismo apellido que en el estado de cuenta):

Patient Account Number: *
Numero de Cuenta del Paciente:

Payment Amount: *
Monto del Pago:

$

Additional Comments:
Comentarios Adicionales:

Contact Information

* Required Fields

Your Name (Payor):*
Tu Nombre:

Your Contact Phone Number: *
Numero de Telefono:


Instructions: Click on the Submit Button below to be taken to our external payment processor website (Touchnet) to complete your Credit Card Payment: