Billing Records Request Form
For patients, parents or guardians, and personal representatives requesting by mail or fax. Include a copy of your government photo ID and, if requesting for someone else, your proof of authority.
Download PDF →Forms & Downloads
Prefer paper? Print, sign, and mail or fax.
The online Request Records page is the fastest route. If you would rather send a paper request, or you are an attorney or representative who needs the patient's signed authorization, download the forms below.
Authorization for Release of Billing Records
The HIPAA authorization a patient signs so records can be released to an attorney, insurer, or other third party. Attorneys: have your client sign this and send it with your request.
Download PDF →Where to send paper requests
Mail: Sunset Billing Archive, c/o The Buckson Group, LLC, 2624 Timber Dr, Suite 151, Garner, NC 27529
Fax: 888-518-4948
Write the patient's name and date of birth on the fax cover sheet so we can match it to your request. Do not include Social Security numbers.