Select the form you need from the list on the right side of your screen. Download, complete, print, sign, scan and attach it below.
We are partnering with Sharecare Health Data Services to better care for you.
FMLA/Disability Paperwork is complex and takes time away from our ability to care for you when you're in the office or during phone consultations.
Effective December 4, 2017, all FMLA/Disablity forms will be processed by Sharecare HDS. There is a $30 fee to complete all of the necessary paperwork.
Please complete, sign and date the FMLA/Disability Authorization form available on this page. You may submit it together with the FMLA/Disablity paperwork here.
Sharecare will contact you either by email or phone within 48 hours to accept your $30 payment.
Once payment is received, you paperwork will be completed in 5-7 business days and sent to the recipient you designated on your FMLA/Disablity Authorization Form Request.