MedPeds Policy on Forms and Letters

Our providers will be more than happy to complete forms and letters for school, work, etc. To avoid fees, provide forms and request letters during your office visit. If requests are made or forms are provided more than 24 hours after your visit, we charge a small fee for EACH FORM OR LETTER, as follows:

• Most short forms (school, work, camp, MVA, etc.) -- $10.00
• FMLA, disability, or other long, complicated forms -- $60.00
• Letters -- $20.00 – Please provide a sample letter of what you would like the provider to say.

Fees must be paid prior to our completing the form or letter.

Reminder: Fees are waived for short forms that are completed during an office visit and also waived for patients with state insurance. Bring your form to your office visit, or at least no longer than 24 hours after your visit.