Patient Notebook

East Baton Rouge Dept of EMS

P.O. Box 669482

Dallas , TX 75266

Phone: (225) 234 - 0719

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1.

First Name *

M.I.

Last Name *

Account Number *

Email Address

2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel