Courtesy Services

	FAX	MAIL	E-Mail
Who can request it?	The patient, the parent or the legal guardian.	The patient, the parent or the legal guardian.	The patient, the parent or the legal guardian.
How much it costs?	Up to 10 pages:no charge 11 to 30 pages: $10.00 (Admin fee) + $0.50 per page (transmission fee) 31 to 50 pages: $10.00 + 0.35 per page 50+ pages: $0.75 per page. All fees must be paid upfront and are non-refundable.	1 page to 50 pages: $35 + cost of shipping (certified mail with return receipt) 51 pages to 100 pages: $45 + cost of shipping (certified mail with return receipt) to 101 pages to 150 pages: $75 + cost of shipping (certified mail with return receipt) All fees are charged upfront and are non-refundable. A tracking # will be provided.	$21 up to 35 pages (or 1MB) $28 up to 50 pages (or 2MB) $45 between 50 pages and 150 pages (or 2MB to 5 MB) Files above 150 are split in files of 150 pages and charged separately All fees must be paid upfront and are non-refundable.
Do I have to fill out a request form?	Yes. Please fill out the form at this link	Yes. Please fill out the form at this link	Yes. Please fill out the form at this link
Timeframe	10 business days from the date the request is submitted and cleared	10 business days from the date the request is submitted and cleared	10 business days from the date the request is submitted and cleared
How do I pay the fees?	All fees are charged when your request is processed. A valid credit card is required.	All fees are charged when your request is processed. A valid credit card is required.	All fees are charged when your request is processed. A valid credit card is required.

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