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<!– prod_phreesia_25 Pay Now Button (Medium Button Orange template) –>

<link rel=”stylesheet” media=”all” href=”https://patient.phreesia.com/resources/buttons/css/payForm.css” />

<form id=”phreesia_payForm” name=”phreesia_payForm” class=”phreesia_payForm phreesia_payForm_med phreesia_payForm_med_orange” action=”https://z3.phreesia.net/z3/patient/Payment.aspx/Start” method=”post”>

<input type=”hidden” name=”encrypted” value=”nbQ3NEXtPyONdOyRAwR6Peph8LlLEt4w1gJjGWC43Ao3cLLv_i0QJ3KSRPxVYF11Hli76RqZFwV7wEOHgmFZoqoW63Ao7d5rgfuNxbfqjhoRMGYI9KZ2Zo41LzJNxnBqfc46GLyQ-Vr0cmjU_lFB5Wq6cbji1CK45fPhYjAmQvc1″>

<a class=”phreesia_butPay” href=”javascript:document.getElementById(‘phreesia_payForm’).submit();”>Make a Payment</a>

</form>

<!–End prod_phreesia_25 Pay Now Button–>