Thank you for your interest in Gravity Payments. Please fill out the form below.

  • Please enter a number from 0 to 100.
  • This is required to approve your account, unless you are a brand new clinic.
    Max. file size: 10 MB.
  • If you do not have checks, you may attach a letter from your bank signed by a bank representative that includes both your routing and account number.
    Max. file size: 10 MB.
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If you have any questions or need any assistance with this form, please feel free to reach out to the Gravity Payments Team at 206-388-5910