Urgent Care

Letters (Insurance, Work, School, Housing, etc.)

$100–$150
Fee varies depending on the complexity of the request and the amount of time required.

Emotional Support Animal (ESA) Letter

$100

Please note that an ESA letter is only provided when, in your provider's clinical judgment, it is medically appropriate and supported by your treatment history. Payment of the fee does not guarantee that a letter will be issued.

EDD / Family & Medical Leave Act (FMLA) Forms

$150

Standard Disability Forms

$100
Includes the first 30 minutes of provider time.

Additional Provider Time
$50 per additional 15 minutes

This applies to complex reports, extended disability documentation, appeals, or additional paperwork requiring review beyond the initial 30 minutes.

Your appointment time is reserved exclusively for you. Missed appointments and late cancellations prevent other patients from receiving care.

Follow-Up Appointment No-Show Fee

$100

Initial Consultation No-Show Fee

$150

If you need to cancel or reschedule your appointment with your psychiatric provider, please provide at least 24 business hours' notice to avoid a cancellation fee.

The following forms are available for new and existing patients:

• New Patient Adult Intake Forms

• Adolescent Intake Forms

• Authorization for Release of Information

These forms can be completed prior to your appointment to help ensure your provider has the information needed to provide the highest quality care.

Many administrative requests require your provider to carefully review your medical record, evaluate clinical information, exercise medical judgment, and prepare individualized documentation outside of your scheduled appointment time. Unlike office visits, these services are often not covered by insurance.

Charging for these services allows our providers to dedicate the necessary time to complete your requests accurately while continuing to provide timely, high-quality care to all of our patients.

If you have questions about a particular form, letter, or administrative request, please don't hesitate to contact our office. We're always happy to discuss what is needed and provide an estimate of any applicable fees before work begins.

To ensure each request receives the time and thoughtful attention it deserves, please allow 5–7 business days for the completion of forms, letters, and other administrative requests.

Documentation is completed only for established patients and is based on your psychiatric provider's clinical assessment, medical record, and professional judgment. While we are happy to assist with requests for disability forms, workplace or school accommodations, insurance documentation, Emotional Support Animal (ESA) letters, and other reports when clinically appropriate, completion of a form or letter does not guarantee approval of benefits, accommodations, insurance claims, or other third-party requests.

Some requests may require additional evaluation or updated clinical information before documentation can be completed. In these situations, your provider may recommend scheduling an appointment to discuss your request and ensure that any documentation accurately reflects your current condition and treatment.

Thank you for your understanding and cooperation. These policies allow our providers to dedicate the necessary time to prepare accurate, individualized documentation while continuing to provide timely, high-quality care to all of our patients.