Recurring Credit Card/ACH Payment Authorization

This will take you to an encrypted and secure form to enter your credit/debit card authorization.

Right Click Blue Button Above to copy link for email purposes.  Copy and Paste into email if needed.

This will take you to an encrypted and secure form to enter your Bank account authorization.

Right Click Blue Button Above to copy link for email purposes.  Copy and Paste into email if needed.

If needed, you can download the credit card or ACH authorization form here.  Be sure to send to Home Office.  Bookkeeping@HealthAllianceNetwork.com