Special Payment Arrangements
If have contracted with FemCap for alternative payment arrangements, or if you are a clinician and need to submit payment, please follow these steps:
- Fill out the form below using your credit card's BILLING information
- Click the "Process Secure Payment Button - You will be taken to the secure payment's page
- OPTIONAL - Enter your shipping information (if different than the billing information) and click "CONTINUE"
- Enter your Credit Card Information and click "CONTINUE" to process the transaction
- Send us your order form via mail or FAX
If you have any questions please contact us for assistance.
Credit Card Billing Information