Make a Payment Online - Bellarine Community Health

If you have to make payment for a BCH service, simply fill out the form below, with your payment details and click submit.

If you have any issues please contact Finance on 1800 007 224 or [email protected]

First Name *

Last Name *

Email *

Phone

Notes to BCH

Please choose one of the options below: *

Invoice # *

Debtor ID *

Amount ($AUD) *

Checkboxes *

I have authorised BELLARINE COMMUNITY HEALTH PTY LTD - ABN 16 627 788 836 -031 to deduct the nominated amount from my credit card on receipt of this form.*

Stripe Credit Card *

This page is insecure. Credit Card field should be used for testing purposes only.

Card

Name on Card

Checkboxes