Get Help

You can request a Balance/Detail Bill or get help with MyChart access issues or other non-medical issues by completing the online form below. If requesting a Balance/ Detail Bill, please provide dates of service. Please allow 2-3 business days for a response.


* Indicates a required field



Patient Information:


(MM-DD-YYYY)



Dates of Service (if applicable):


(MM-DD-YYYY)

(MM-DD-YYYY)

 


Requestor Information:


Preferred method to send:
Release of Information on File:

Send ROI, email ROI-requestor3@dm.duke.edu or fax to 919-620-5165

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