* - required entry
* Patient Name
* e-Mail
You will receive an e-mail
confirmation automatically.
* Phone Number

* Credit Card
* Cardholder Name
* Card Number
Please enter without
spaces or dashes.
* Expiration Date
Format (mm/yy)

* Account Number
* Payment Amount
Format (XXX.XX)
* Payable To:
Surgery
Orthopedic & Sports Surgery Center

Clinic  - Orthopedic Clinic of Appleton
Brian Lohrbach, MD, SC
David Eggert, MD, SC
Robert Hausserman, MD, SC
Padraic Obma, MD, SC
Kenneth Schaufelberger, MD, SC

Clinic  - Valley Orthopedic Clinic
Valley Orthopedic Clinic, SC

David Kuplic, MD
David Ritzow, MD
Errol Springer, MD
Jay Minorik, MD
Todd Derksen, DPM
Bradley Borgen, APNP
Eric Bowen, APNP
Eve Pomrening, APNP
Kara Brochtrup, APNP
Kim Willison, APNP

Comments