Documentation Requests

Please complete the form below and provide details regarding your requests.

Please note if you are requesting a full report regarding diagnosis, recommendations, and/or accommodations, preparation can take between 2-4 hours and is billable at $400/hr. If you are simply looking for a brief summary of diagnosis, findings, and recommendations on medication there is no charge. Turn around time can take between 3-4 weeks for extensive reports. Please review and complete the form below if you have not already.

Requesting Documentation- Existing Patients ONLY
I am requesting the following:

Thanks for submitting!