Client Payments

Client Payments

Triangle Family Services has suspended all in-person services, in compliance with community-wide measures to protect against the spread of COVID-19. Our staff continue to serve clients through telephone, email and other electronic platforms as possible.

To make payments for remote services you are receiving, please complete the payment form below. Please note: This is a secure form of payment, contact and billing information is only being collected for program service delivery purposes.

* Please only use this page to make electronic payments. Do not use any payment apps for client fees. If you’re unable to process a payment using this page, please contact your Case Manager or Therapist to discuss payment options.

Payment Amount*
Program Area*
I am making a payment for services in:
- Developing a Safe Environment (DOSE)
- Mental Health Counseling/Therapy
- Supervised Visitation
Service Type & Date of Service, Additional Comments*
Please note the DATE of SERVICE to which your payment is related. List the NAME of your Case Manager or Therapist and any additional comments and/or notes from them.
Client Name*
First Last
Your Name (if you are not the client)
Relationship to Client
Your Email*
Your Phone*
Billing Information*
Street Address Address Line 2 City State ZIP Code
Credit Card Information*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Payment Total
$0.00
Name
This field is for validation purposes and should be left unchanged.

*Do not click “Submit Payment” more than once, or refresh the page. Payment will be submitted and if the transaction is accepted, you will receive an automated email receipt shortly after.*