Medical Records & Letters

Certain administrative services fall outside of standard medical care and are not covered by insurance. These services require additional provider time and resources and incur a self‑pay fee. This includes medical records and letters prepared by our licensed Therapists, Nurse Practitioners, Psychiatrists, and Psychologists and Dietitians for work, school, housing, disability, and travel needs.

Some letters require a specific number of clinical visits before they can be issued. These visits may be covered by insurance, but providers must agree to release medical records or write a medical letter. Completed documents are uploaded to your patient portal, and we can fax them upon request. Please allow 7 business days for processing.

Medical Records 

Fee: $50.00
A medical records release form is required for all requests.

How to Request Medical Records:

1. Email medicalrecords@washncgroup.com with your name, date of birth, provider’s name, and the contact information (including fax number) of the person or organization receiving the records.
2. Once your request is approved, complete the Medical Records Release Form.
3. Submit medical records payment here for $50.00
4. Records will be uploaded to your portal and faxed to the number you provided within 7 business days.

Medical Letters

Some providers may write letters on your behalf. More complex letters—such as FMLA or Emotional Support Animal (ESA) letters—may require 3 months of treatment and/or 6 visits before they can be completed.

How to Request a Letter:

1. Ask your provider how many additional visits, if any, are required before a letter can be issued.
2. Email medicalrecords@washncgroup.com with your name, date of birth, provider’s name, and the contact information (including fax number) of the person or organization receiving the letter. We will confirm the fee for your request.
3. Complete the Medical Records Release Form only if the letter will be sent to a third party.
4. Submit payment using the appropriate link below.
5. Your letter will be uploaded to your portal within 7 business days, and we can fax it upon request.

Letter and Form Pricing:

Standard Clinical Letters / 1‑Page Letters — $100
Simple, factual documentation that does not require extensive clinical justification.
Includes: Work Excuse, Return to Work/School, Treatment Verification, Medication Verification, General Support Letters, Other 1‑Page Letters.

Extended or Form‑Based Letters (2‑Page Detailed or Custom) — $200
More detailed or customized letters requiring additional narrative or formatting.
Includes: Detailed 2‑Page Letters, Custom Narrative Letters, Extended Verification Letters.

FMLA / Disability / ESA / Accommodation Forms — $400
Higher‑complexity forms requiring clinical reasoning, functional assessment, and multi‑section documentation.
Includes: FMLA Forms, Short‑Term Disability Forms, Long‑Term Disability (Basic), ESA Housing/Travel Letters, Academic Accommodation Letters, Workplace or Housing Accommodation Letters, Multi‑Page Treatment Summaries.

Comprehensive Reports (NPs / Psychiatrists Only) — $500
Highest‑complexity documentation requiring extensive chart review, clinical justification, and multi‑system assessment.
Includes: Long‑Term Disability Narrative Reports, Legal‑Related Clinical Letters, Immigration Hardship Letters, Complex ADA Accommodation Reports, Extended Medical Leave Reports.

Payment Policy

All administrative fees must be paid in full before a letter or form is released. Fees are non‑refundable once the document has been prepared.