What to know
- You'll need the information on your billing statement to fill out this form.
- We'll process your payment within three business days.
- If you prefer, you can mail a check or credit card payment to the address listed on your billing statement instead of filling out this form.
Note: Park Nicollet Health Care Products includes: Park Nicollet Health and Care Stores, HealthPartners Home Medical, Park Nicollet Hearing Center & Store, Park Nicollet Orthotics & Prosthetics, Park Nicollet Sleep Store.