Before you start, please have the following ready:

  • The form you need completed (FMLA, disability, school, or other medical-related forms)
  • A valid photo ID
  • A credit or debit card

This request process is for patients and authorized caregivers. Please allow 7-10 business days for your forms to be completed. If you have any questions, please refer to our Help Center.

Request a Form

Submit a new form request for completion by your healthcare provider.

  • Upload the form you need completed
  • Track your request status online
  • Typical turnaround time: 7-10 business days
  • $30.00 per form
Start a Request
Form Request Options

Request a Form

Submit a new form request for completion by your healthcare provider.

  • Upload the form you need completed
  • Track your request status online
  • Typical turnaround time: 7-10 business days
  • $30.00 per form
Start a Request

Update an Existing Request

Need to make changes to a form you've already submitted?

  • Update dates, restrictions, or other information
  • Request revisions to a previous submission
  • $20.00 per form

Submit a Follow-Up Form

Request an extension or additional documentation related to an existing request.

  • Extensions
  • Follow-up paperwork
  • $25.00 per form

Check Request Status

Track the progress of your request.

  • Use your confirmation ID (located in your confirmation email) to view the latest status
Check Status