Name on Card :
Visa/Mastercard/Amex :
Card Number :
Card Expiration Date :
CVV Security Code :
Total Charge Amount :
Card Billing Address :
Client's Social Security # :
Client's Name :
Email :
Phone :
Service Purchased :
Medical Specialties:
Payment
B''H
Secure payments using your major
credit card or for PAYPAL, click
the link above.

Please fill out the entire form below
for a valid receipt if you do choose
to pay directly via credit card.
Copyright © 2003
FMG America - All Rights Reserved
Payment Via PAYPAL

Click the PAYPAL icon above to pay using your credit card.  Or contact us at
payment@fmgamerica.com for other options.

-Use
information@fmgamerica.com as the recipient's email for your PAYPAL payment email.

-PAYPAL's E-Commerce solutions are simple, private, and provide our clients with an alternate
secure payment option.  Each payment creates a binding and traceable receipt of the transaction
for your records.

-Any questions or problems regarding PAYPAL, please contact their customer service directly at:
1-888-221-1161

-For all other payment and billing issues please contact payment@fmgamerica.com.
We ensure U.S. medical placement for all qualified candidates.
About Us | Welcome | Important Links | Charities | Payment | Contact Us   
Due to our fees associated with credit card processing, you may also be eligible for a
discounted fee (up to $100 off) if you pay with a money order or bank check.  For
more information email
payment@fmgamerica.com.