Learn how to modify and re-submit your PatientBank request form. This includes:
- Editing content of request form. Correct a typo, add an alternate name, or specify different records to be returned.
- Changing fax number or email address. Send your request form to a different fax number or email address, if your provider never received it.
Step 1: Go to the Modify Request page
If you have a PatientBank Account:
- Log into your PatientBank account here.
- Select the “Requests” tab on left sidebar.
- Click the request that you want to modify.
Modifying a request with your PatientBank account
If you do not have a PatientBank Account:
- Locate your initial confirmation email from PatientBank.
- Click the “Modify your request” button.
Modify request via email
Step 2: Edit request content
- Click the “Modify” button.
- Make any necessary edits to your request form.
- Click “Save and Review” to save changes.
Edit request content
Step 3: Re-submit your request
- Click the “Send request” button.
- Select the default contact, or enter an alternate fax number or email address into the “Custom fax or email” field.
- Click “Send request.”
If we can provide further support, please reach out by email at firstname.lastname@example.org or by phone at (855) 972-8436.