Make a Payment - Enter Amount | ACI Payments, Inc.

The University of Texas Health Science Center At Houston

SOD_UT_DENTISTS PATIENT_PYMTS

Enter your Payment Amount, including any penalties or interest, select Payment Option, then click "Continue" to proceed with the payment process.

*	First Name:
*	Last Name:
*	Email Address:
*	Phone Number:
*	Patient Account Number:
*	Sex:	cde-Sex-5
*	Date of Birth (DOB):	/ /
*	Sex:	cde-Sex-9
	Race/Ethnicity:	cde-Race-9
*	Are you the patient or guarantor?:	cde-Areyou-7
*	Which clinic is this payment for?:	cde-Whicclin-8

*Payment Amount

$ .

Payment Options:

Debit Card

Debit Card

Credit Card

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