Completion of Forms Information

An administrative fee is charged for the completion of all documents/questionaires presented by patients for completion by providers. (See Fee Schedule below.) These documents include but are not limited to disability insurance benefit forms, Family and Medical Leave Act (FMLA) forms, school forms and medical reports.  These fees are due prior to the completion of the forms.  Our priority is providing treatment to our patients, therefore, we ask that you give us a minimum of 10 business days for completion of forms.

Note:  Our providers do not do disability evaluations. If you are requesting assistance in completion of a disability claim, please make note of the following:

  • CPG does not “give” disability. CPG can only report symptoms and response to treatment to the company that handles your disability insurance.  Fees are charged for completion of paperwork.  Copies of medical records for a disability claim are provided to the disability company at no charge to the patient.
  • If you are disabled and cannot work, our goal is to help you to return to work. You will be scheduled with a therapist and psychiatrist to help with issues that are preventing you from working.
  • We do not back date disability. This means, that we can only attest to your current disability that we have evaluated you for, and we will not be able to provide back dated information.
  • You must do your part to maintain current with disabilty regulations by keeping scheduled appointments. We will notify your disability carrier if appointments are not kept.
  • We ask that you give us a minimum of 10 business days to complete disability forms and up to 30 days for requests that require the addition of copies of your medical records.

Full detailed information about CPG’s Disability Claims Policies are available upon request from your psychiatrist, therapist, or the office receptionist.

Fee Schedule:

Family Medical Leave Act $25
One Page  form $25
Multiple page form $60
Narrative Summary $150 1st hour (minimum 1 hour)