Patient Forms

Forms Fee Policy Update

Effective November 7, 2022, a fee will be applied for any paperwork that patients request their provider to complete.

What kind of paperwork and forms do this policy refer to?

• Adoption/foster parent physical
• Disabled parking pass
• Employment physical
• Family medical leave (FMLA)
• School or camp physical
• Pre-operative forms

How much do you charge for forms request?

• If your form is 2 pages or less (each side is considered a page), the form fee is $25.
• If your form is more than 3 pages, the form fee is $50.

Fees are due at the time of drop-off. This is not a covered item by the insurance providers.

Is an appointment required to request for forms to be filled out?

If you had a recent visit pertaining with the same diagnosis, you can drop off your forms to our front desk staff. Your provider may still request to see you in an office visit to discuss your health concern pertaining to the form.

If your form is related to a healthcare issue that has not been discussed with your provider, you must schedule an office visit first.

What is the turnaround time?

Completion of forms may take up to seven (7) business days, excluding an office visit day if deemed necessary.

Why are we implementing this policy?

Completing these forms requires considerable time, research, and follow-up, often extending beyond our regular business hours. Unfortunately, this work is not reimbursable by insurance. Most medical facilities already charge fees for form completion, and we are among the last in the area to implement this practice.

We understand that this change may be inconvenient or create challenges for some patients. Our commitment is to remain transparent and to work with you to meet your needs whenever possible. We appreciate your understanding and are grateful that you continue to trust us as your primary care providers.