DTT&C Payment Form

Dream Team Temping & Consulting Payment

Thank you for utilizing this form to make a one-time, easy payment.

This form is for payments to the agency only.

*Your temp must be paid separately and payment for temps cannot be accepted by the agency or through this portal.

Question Title

* 1. Practice Name

Question Title

* 2. Invoice Amount

Question Title

* 3. Payment Amount

$

Minimum amount: $25 USD

You will pay at the end of this survey.

Question Title

* 4. Invoice Date

Question Title

* 5. Your Name (Individual authorized to make payments on behalf of the practice). *If you are not authorized to make payments, submit to your practice owner/manager.