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Demonstration site. Please do not enter real personal or health information. Forms here are for testing only.
If you or someone you know is in crisis, call or text 988, the Suicide and Crisis Lifeline. In an emergency, call 911.

Make a payment

Pay Bridges program fees online.

Pay program fees online for yourself or for a participant. You receive an emailed receipt. Payments are applied to the participant’s account within one business day.

Your information

Who the payment is for

If you are paying for yourself, enter your own name.

Your client number is on your receipts and schedule. We no longer ask for any part of your Social Security number.

Card

Online card payment is not connected on this copy of the site. Sending this form records the payment request for staff but does not charge a card.

DUI Program payments can also be made at the Florin Road office by money order or cashier’s check. No cash or personal checks.