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15 – SSI Disability Requests for Medical Records
$
18.00
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13 – Notarized Affidavit for No Radiology Records Available
$
36.00
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11 – Notarized Affidavit for No Physician Billing Records Available
$
36.00
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Details
10 – Notarized Affidavit for No Facility Billing Records Available
$
36.00
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Details
14 – Notarized Affidavit or Deposition Questionnaire – Choose this Option if You Already Received Records and only Need an Affidavit or Questionnaire Completed
$
36.00
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Details
12 – Notarized Affidavit for No Medical Records Available
$
36.00
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09 – Expedited Shipping
$
50.00
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08 – Radiology Records (CD or Film) Without Affidavit
$
23.00
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07 – Notarized Affidavit or Deposition Questionnaire for Radiology Records
$
36.00
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Details
05 – Notarized Affidavit or Deposition Questionnaire for Physician Billing Record
$
36.00
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Details
04 – Notarized Affidavit or Deposition Questionnaire for Facility Billing Records
$
36.00
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Details
06 – Notarized Affidavit or Deposition Questionnaire for Medical Records
$
36.00
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Details
01 – Facility Billing Records (1-10 Pages)
$
25.00
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03 – Medical Records
$
25.00
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02 – Physician Billing Records (1-10 Pages)
$
25.00
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