Markham Fertility Centre Accounting – TEST

FOR MARKHAM FERTILITY CENTRE PAYMENTS ONLYPlease check the top of your invoice to ensure it states “Markham Fertility Centre.
Fields with red * are required fields.

Street Address City Province/Territory/State Postal Code/Zip Code Country
For secure VISA, MasterCard or AMEX payment please complete the following;
Card holder's name
Credit card number

Expiry Date (mm/yy)