By submitting this electronic request form you are authorizing A Personal Choice to complete Famliy Medical Leave Act (FMLA), Short Term Disability, or Return to Work forms and send these completed forms to you or, if required, your employer.
After you pay the required records fee and click "Submit", our office will recieve your request. This fee is required for any form your employer requires.
Your forms will be completed within 72 hours (three business days) of your post-operative visit.
You will be notified by email when your release forms have been completed.