Request for Records, Letter, or FMLA
Request for Records Policy­ Garrett Counseling 
(A stated by the State of Alabama ­ Section 12­21­6.1 Alabama Code Reproduction)

One dollar ($1) for each page of the first 25 pages ● Not more than 50 cents ($.50) for each page in excess of 25 pages ● A search fee of ten dollars ($10) ● Administrative fees ­ includes additional cost for mailing/faxing ($40.00) if needed for mailing. Our default is to email records therefore an email is required.

Note: All summary letters for court, lawyers, school systems, work and clinical summaries for other reasons cost $150.00 per letter
Note: Anything related to court requires you complete our court policy form. You will be sent that form to complete before anything related to court is fulfilled.
Note: All email exchanges with lawyers cost a prorated cost of $150.00 per hour
Note: FMLA paper cost $50.00 each time our office completes the form

NOTE: If you need a summary of your appointments (past or future) you can print this for free from your client portal.

You must make your request in writing with the following information. Payment must be received before records can be released. Please allow two weeks for processing from the time payment is received. 

billing@garrettcounseling.com

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Full Name of Client *
Email of Client or Guardian *
Phone Number of Client or Guardian *
Date you were seen at our office *
Who was your counselor? If you can remember... *
Which of the following do you need? *
Required
Who do you want the records (or letter) sent to? If you need them for court or disability you will need to have them sent directly to your lawyer.  (NOTE: You will have to complete a release of information and email it to us directly with this persons name listed).  NAME of person


 *
Company of person to release records (or letter or FMLA paperwork) to. *
Email for who you wants records (or letter or FMLA paperwork) sent directly to. *
CONFIRMING - What do you need sent? Check ALL that apply. *
Required
By typing my name in, I am confirming I am this person or that I am the guardian of this client.  *
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