Pay your invoice online - Step 1: patient/payer information | CHL

You can pay your invoice via this form. Your payment will be effective immediately.

All data are treated in a confidential manner.

Information about the principal/payer

Title : *

Mr

Ms

Mrs

Surname :

First name :

Address :

Email :

Tel. with prefix :

Information about the patient

The patient is the payer

Title : *

Mr

Ms

Mrs

Surname :

First name :

National Health Fund ID number :

Date of birth :

Day

Month

Year

Please specify at least one of the two fields above.

Patient no. (provided on the invoice) :

To what does the patient number correspond?