Forms and Paperwork Requests - Cerebro Wellness

Administrative Services & Document Policies

At Cerebro Wellness, our priority is providing high-quality clinical care. The completion of disability forms, medical letters, and legal documentation requires significant time and detailed review of clinical records outside of your scheduled appointments.

To ensure all requests are handled with accuracy and within a professional timeframe, the following policies and fees apply to all documentation requests effective January 1, 2026.

Fee Schedule

Fees are per document/form and must be paid in full before the document is released.

• Standard Documentation (1–5 pages): $50

• Examples: FMLA forms, short-term disability, employer-specific health forms.

• Complex Documentation (5+ pages): Starting at $75

• Final cost determined by the length and clinical detail required.

• Emotional Support Animal (ESA) Letters: $99

• Includes clinical review and formal housing/travel documentation.

• Multiple Documents: $50 per individual document.

Submission Timeline & Rush Requests

We require a minimum of five (5) business days from the date of payment and submission to complete all paperwork.

• Standard Processing: 5 Business Days.

• Expedited Processing: If you require a document in fewer than five business days, an additional expedited fee will be applied to your request.

How to Request Your Documents

1. Submit the Form: Fill out the form below and submit the documents through this page.

2. Invoice & Payment: An invoice will be sent to your patient portal. Processing begins once the fee is settled.

3. Delivery: You will be notified via email once the document is ready to be downloaded through our Patient Portal.

Medical Document Request Form

Patient Name

First

Last

Date of Birth

Patient Email

Forms Agreement or

Document Type

Date Document is Due

Note: Standard turnaround is 5 business days. Requests due sooner will incur an expedited fee.

Requested Turnaround Time

Standard 5 Business Days - No extra charge
Expedited 2-4 Business Days - $25 Fee
Emergency 24-Hour Turnaround - $50 Fee

Additional Details or Specific Requirements

Please list any specific information, dates, or clinical details that must be included in this document to ensure accuracy.

Upload Blank Forms

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

Please ensure your personal sections of the form are already filled out before uploading. If you are requesting a ESA letter, please upload a photo of your pet.

Terms of Agreement

I understand that each document under 5 pages uploaded will incur a $50 fee.
I acknowledge that Cerebro Wellness requires 5 business days to complete paperwork.
I agree that requests due in less than 5 business days will have an additional expedited fee.
I understand that work will not start until the invoice is paid in full, and the 5-day clock begins after payment.
I understand the turnaround time and associated fees.
I acknowledge the pre-payment policy and its implications on the start of work.