![Billing Records](/content/dam/dignity-health/images/socal/1280x320-detail-clear-slight-overlay-on-bottom/socal-019.jpg/_jcr_content/renditions/cq5dam.web.1440.405.jpeg)
Request for Access to Billing Records
For access to billing-related health information about you, and to enable us to process your request for a billing statement, please download the following form, complete, and email to: [email protected].
English
PATIENT’S REQUEST FOR ACCESS TO BILLING RECORDS
Spanish
SOLICITUD DE ACCESO DEL PACIENTE A LOS REGISTROS DE FACTURACIÓN