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Pay your invoice

Online or by check

Online Payment

Step 1 of 3 - Patient Information

Required*
Child's first name Child's last name

Click on the plus to add up to 4 children

First name*
Last name*
Address*

Number and street address
Address - Line 2

Appt #
City*
State*
Zip code*
Country
Email*
Enter Email Confirm Email
Phone Number*

Amount:*

Example: 126.89 or $126.89
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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Payment Per Check

Checks written to AHSS should be sent to:

Autism Home Support Services
PO Box 639561
Cincinnati, OH 45263-9561

Question?

Phone Number: 866-222-0382
Email: [email protected]

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