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For all document requests contact our office first at 888-288-0040 or submit the form below to be assigned a tier based on the actual request.
Tier 1 Simple Basic
Fee $25
For simple, straightforward 1-page document requiring minimal clinical detail.
Tier 2 Basic
Fee $50
For short, straightforward documents requiring minimal clinical detail.
Tier 3 Standard
Fee $100
For forms requiring moderate clinical information or short narrative sections.
Tier 4 Detailed
Fee $175
For multi-page forms requiring detailed clinical descriptions, functional assessments, or treatment summaries.
Tier 4 Comprehensive
Fee $200
For extensive, multi-page forms requiring significant clinical detail, functional impairment descriptions, and treatment justification.
Important Notes:
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Payment is due before forms are released.
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Fees cover time spent reviewing records, completing forms, and ensuring accuracy.
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Turnaround time is typically 7-10 business days unless expedited.
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Some forms may require an appointment if additional assessment is needed.
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