DISABILITY: There will be a fifteen dollar ($20) charge for each disability form and a seven to ten (7-10) BUSINESS day waiting period for all disability forms.

FAMILY MEDICAL LEAVE ACT FORMS: There is no charge but there is a seven to ten (7-10) BUSINESS day waiting period.

HANDICAP PARKING PERMITS: No charge.

MEDICAL RECORDS COPYING FEES: Payment is due prior to mailing or at the time of pick up.

• One dollar ($1) per page for the first ten (10) pages.
• Fifty cents ($.50) per page for pages eleven (11) through fifty (50).
• Twenty five cents ($.25) per page for pages fifty-one (51) and above.
• Five dollars ($5) per CD (X-Ray/MRI/Medical Records)
• Five dollars ($5) per page printed (X-Ray/MRI films)
• Requests for medical records to be provided within forty eight to seventy two (48-72) hours will be processed with an
• additional ten dollar ($10) fee.
• Please call our office for specific payment details if the following applies:
  • Medicaid patients