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Patient Acknowledgment for Credit Card Use.

By choosing to pay with a credit card for services rendered at the Madison County Public Health Department, you agree to the following terms.

Medical Debt Classification: Payments made by credit card are treated as personal debt rather than medical debt, meaning certain federal and state protection associated with medical debt may not apply.

Credit Reporting Impacts: Paying with a credit card waives protections that prevent medical debts from being reported to credit bureaus, which may affect your credit report and score.

Interest and Collection Protection: This payment method waives specific protections against wage garnishment, properly liens, and limits on interest rates that typically apply to medical debt.

*By checking the Acknowledge box below, you affirm that you understand and accept these terms and choose to proceed with this payment method with full knowledge of these considerations.:
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