Family Medical Leave Act
We are happy to complete disability and FMLA forms for you. The cost of FMLA will be $25 per set. This must be paid in advance. We will only complete the physician section of the forms. Please leave this completed form along with your disability/FMLA form(s) and your payment with the receptionist. Please allow 10 business days for processing.
FMLA / Short-Term Disability Form
Request My Records
Do you need to obtain a copy of your medical records from our office? Do you need our office to request your medical records from another doctor’s office? Click here to print a copy of our Medical Records Release form.
Simply complete and return to our office via fax at (913) 677-4514 or via email at