Contact UsCurrently selected Purpose and VisionNewsEventsAwardsContact UsCurrently selectedInclusion, Diversity and Equity Home|About Presbyterian|Contact Us|Request for Billing Information and Assistance Request for Billing Assistance Page Image Page Content​The Presbyterian Customer Service Center is here to help you with any inquiries or issues you may have. Please provide us with the following information so that we may assist you.​ Please complete the form below. * = indicates required fields First Name* Last Name* Address* Address Line 2 City* State* Select state ZIP Code* Phone Number* Best time to call Select one Mornings Afternoons Evenings Fax Email Address* Assistance required* (check all that apply) Need Account Balance Question(s) regarding Balance Request for Itemized Bill Other: (please specify) Account Number* (or Social Security Number) Service Date* mm dd yyyy Type of Bill* Select one Hospital Physician Ambulance Reason for Inquiry* Attach Supporting Documentation Total size of all files should not exceed 4MB. Allowed file types: .doc, .docx, .rtf, .xls, .xlsx, .pdf, .png, .jpg, .jpeg, .gif File 1 File 2 File 3 Add Another File The control cannot be rendered without valid Public and Private keys. Additional Content Back To Top Sidebar Content