If you experience problems submitting a payment, please contact Diabetes Express at 1-866-418-3392.

Make a Payment to Diabetes Express

To simplify for your experience, Diabetes Express has made it easy to make a payment towards your account. In order to complete your payment, you will require your customer number which can be found on any previous invoice that has been provided to you by email. Please use that email as a reference to fill out the payment form or contact us for additional assistance with your account information either by phone 1-866-418-3392 or diabetesexpress@bayshore.ca

A receipt of your transaction will be sent to the email address you provide below. Please make your payment using any of the following methods: Visa, MasterCard, Visa Debit, MasterCard Debit or American Express credit card.

Billing Information: Please ensure the following required fields match the name, address and postal code listed at your financial institution

* indicates a required field

Name *

Address *

Suite/Apt

City *

Province *

Postal Code *

Phone Number *

Email *
By providing your email address you authorize Diabetes Express to communicate with you via that email and to send you an emailed receipt.

Client/Patient Information used to identify the individual to whom Diabetes Express is providing product for

Name

Payment Type please select one option*

I would like to pay towards an outstanding balance
I would like to join the Pump Now Pay Later^TM Program

Optional Convenient Service - Auto Fill, Auto Bill™ Service

Bayshore Specialty Rx Ltd. ("Bayshore") offers the "Auto Fill, Auto Bill™" Program for a hassle-free experience. By selecting this option, you authorize Bayshore to automatically process, bill, and ship your recurring orders without advance notice prior to each transaction. Your insurance and any applicable co-pay will be billed directly to your saved card.

Automatic Shipments & Authorization: By opting in, you agree to accept and pay for all recurring shipments until you cancel
Missing or Misplaced Packages: If your tracking indicates delivery but you have not received your package, or if you have questions about a transaction, please contact us immediately at 1-866-418-3392 or diabetesexpress@bayshore.ca for direct assistance rather than filing a bank chargeback.
Cancellation Policy: You may cancel this service at least four (4) days prior to any scheduled refill by contacting us during business hours (Monday – Friday, 8:30am – 7 pm ET, Saturday 10am - 2pm, excluding Ontario statutory holidays).

By checking this box, you authorize us to securely store this card for future transactions and recurring billing. If you choose not to save your card, recurring orders cannot be automatically processed and may be placed on hold.

Your Payment used to authorize the charge to the credit card

Diabetes Express Customer # (Customer ID)*

Total Amount Due

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