Students in front of the University Health Center, University of Georgia

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Patient / Client Information

Full Name:

Date of Birth:

Sample UGA id card
Reference # :
(This is your nine digit student ID number starting with 81 located on your UGA ID card. This is also listed as the reference number on the email that you may have received.)

Amount to Charge to Card:
(Credit Card information will be entered on the next page.)

Contact Information

Local Telephone # :

Mobile # :

Email Address :
(This must be your UGA email address. Example:


Transactions generated today may not be processed until the following business day.
Flags may take more than 24 hours to be removed from your UGA account.
Pay by phone for immediate flag removal during business hours by calling the Business Services Office at 706-542-8621.

Find out your balance by calling the Business Office at 706-542-8621 or by logging onto OpenCommunicator.

For other questions or concerns please contact the Business Services Office at 706-542-8621.

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