Make A Payment

Home / Make A Payment

Enter Your Payment Details Below
KMHC's payment portal is encrypted and secure using Square®
STEP 1: Welcome
This information will be used to process your secure payment
Name*
First Name** Last Name**
Email*
Phone*
STEP 2: BILLING ADDRESS
Address*
Street Address City State ZIP Code
Submit Payment Now
Enter Amount
Total
$0.00
Credit Card Information*
Card Details
Cardholder Name
Consent*
Yes
I hereby agree to Kentucky Mental Health Care, LLC processing a payment on my behalf for the amount listed above.