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Paperwork Policy 

We realize that patients may need to have forms completed for disability or work. We have developed a paperwork policy to assist our clients with getting their paperwork completed in a timely manner. If you have forms that need to be completed, you must schedule an appointment with your provider to get the paperwork completed. Please read, initial, and sign below to acknowledge our paperwork policy.

 

FMLA Paperwork:

1. You will need to sign a release of information

2. Make an appointment for completing you FMLA paperwork

3. Please allow up to 10-15 business days to complete the paperwork

4. Patients must have an established relationship with the provider for a minimum of 6 months 

 

Social Security/Disability/Attorney Paperwork:

1. You will need to sign a release of information

2. Make an appointment for completing any social security or disability paperwork

3. Please allow up to 20 business days to complete the paperwork

 

Formal Letters (504 Letter for School/Emotional Support/Service Dog Letter):

1. You will need to sign a release of information

2. Make an appointment to complete formal letters/504 letters

3. Please allow up to 10-15 business days to complete the letter

 

VA Paperwork:

1. You will need to sign a release of information to the VA with the fax number to your VA counselor

2. Make an appointment to complete any VA paperwork

3. Please allow up to 45 business days to complete any VA paperwork

4. Must have an established relationship with the provider for at least 6 months 

 

 

Paperwork Fee Scale

Diagnosis and/or Treatment Physician Letter

$30.00

Authorization letter to administer medication by a school nurse

$0.00

Educational 504 Accommodations Letter

$25.00

Emotional Support Animal/Service Dog Letter 

$30.00

Medical Record Processing Fee (20-pages or less)

$25.00

Medical Record Processing Fee (More than 20- pages)

$75.00

FMLA

$75.00

Short/Long Term Disability

$100.00

VA Disability Paperwork

$275.00

 

 

 

 

Kind regards,

 

 

 

 

GBMHC LLC DBA Tranquility Behavioral Health LLC