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Notebooks

Pay Your Statement Balance

Please use the form below to submit a secure payment toward your statement balance. You may enter the full balance or any amount you would like to pay today. Be sure to complete all patient information fields so we can correctly apply the payment to your account.
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If you have questions about your balance or need assistance, please contact our office before completing payment.

Superbills are available upon request for self-pay services.

Select the Prepay Option That Works Best for You

  • Fertility Foundations Program

    350$
    Every month
    Includes 1 female initial visit, 1 male partner visit, 2 follow-up visits, and 3 months of ongoing messaging and lab review. Hormone management in early pregnancy is included if needed.
    Valid for 3 months

    • Fertility Foundations Program

      930$
       
      Includes 1 female initial visit, 1 male partner visit, 2 follow-up visits, and 3 months of messaging and lab review. Hormone management in early pregnancy is included if needed.
      Valid for 3 months

      • Continuation of Care

        395$
         
        For former patients of Ashley Jensen. Includes initial transition visit, 1 follow up visit, and 3 months of messaging support with treatment plan coordination.
         

        • Active Fertility Care

          325$
          Every month
          Includes 1 follow-up visit per month, ongoing messaging and lab and ultrasound review, and cycle tracking with treatment adjustments.
           

          • Active Fertility Care

            900$
            Every 3 months
            Includes 3 follow-up visits, 3 months of messaging and lab and ultrasound review, and continued cycle monitoring and adjustments.
             
            • Save $75 compared to monthly pricing

          Prepayment is required to activate your plan and schedule services.

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