Safe, Effective Birth Control

For Health Conscious Women

Special Payment Arrangements

If have contracted with FemCap for alternative payment arrangements, or if you are a clinician and need to submit payment,  please follow these steps:

  1. Fill out the form below using your credit card's BILLING information
  2. Click the "Process Secure Payment Button - You will be taken to the secure payment's page
  3. OPTIONAL - Enter your shipping information (if different than the billing information) and click "CONTINUE"
  4. Enter your Credit Card Information and click "CONTINUE" to process the transaction
  5. Send us your order form via mail or FAX

If you have any questions please contact us for assistance.

Credit Card Billing Information