• Account Information Request

  • Patient Information

  • If you do not have a Patient Account Number

  •  - -
  •  - -
  • Do you need your account balance?

  • If you are providing an e-mail address you are:

    1. Attesting to the accuracy of the address, and
    2. Authorizing children's to answer your inquiry via e-mail.

    Be advised that e-mail is not an entirely secure and private means of communication. The e-mail provider you utilize may be vulnerable to intrusion. If you have strong concerns about the privacy of the information that might be contained in an e-mail to you from Children's Healthcare of Atlanta, you should not provide an e-mail address.

  • Do you have payment arrangement or general questions?

    If you fill in your phone number, a customer service representative will call you to set up payment arrangements.
  • Do you need to change your address?

    This will only change your mailing address, not the guarantor or responsible party.
  • Should be Empty: