Self-Pay & Administrative Fee Schedule

Self-Pay & Administrative Fee Schedule


Psychiatric Services


Medical Weight Loss / GLP-1 Program


General Urgent Care Visits


Emotional Support Animal (ESA) Services


FMLA / Medical Leave / Disability Forms


Other Psychiatric Administrative Letters & Forms



Administrative Services Policy


     Administrative services, including forms and letters, are not covered by insurance and require dedicated clinical time outside of scheduled appointments. Documentation will only be completed when clinically appropriate and supported by the medical record. Submission of a request does not guarantee approval of documentation. Please allow 3–5 business days for completion. Expedited requests may be available for an additional fee, when feasible. Fees are subject to periodic review and adjustment based on time and complexity.