Policies

Documentation Requests & Administrative Fees

At Revive Wellness, we are happy to provide documentation when clinically appropriate and within the scope of your provider’s role. Because requests for records, letters, and paperwork require additional administrative and clinical time outside of scheduled sessions, the following fees apply:

Medical Records Requests
Requests for copies of medical records or other treatment documentation are billed at $7.00 per page.
This applies to records requested by clients, attorneys, disability companies, insurance carriers, employers, schools, or any other third party authorized to receive documentation.
Payment is required in full before records will be released or sent.

Forms, Letters, & Special Documentation
Requests that require a provider to complete paperwork, draft a letter, or prepare documentation outside of session are billed at a flat fee of $150.00 per request.
Examples include, but are not limited to:

- FMLA paperwork
- Emotional Support Animal (ESA) letters
- disability or leave paperwork
- provider-completed forms or letters requested for work, school, housing, or other third parties

Requests for forms, letters, and special documentation are only available for current, established clients who:

- have been seen by a provider in our practice for a minimum of 5 sessions, and
- are actively engaged in treatment with our office at the time of the request

Please note that submitting a request does not guarantee that documentation will be completed or provided. All requests are reviewed on a case-by-case basis and will only be completed when clinically appropriate and supported by the client’s treatment needs.

Payment is required in full before forms, letters, or documentation will be reviewed, completed, or released.

Additional Information:

Some requests may also require a signed authorization for release of information. Processing time begins once payment has been received and any required forms have been completed.

If you have questions about documentation requests or administrative fees, please contact our office prior to submitting your request. 

You may submit your detailed request via email (contact@revivewellnesscenter.com).