Miscellaneous Fee Schedule

SERVICE DESCRIPTIONFEEBILLABLE THROUGH INSURANCE
Letters & Forms

FMLA, University Accommodation Letters, Disability Forms, Etc. (Up to 2 Pages)
$25.00No
Letters & Forms

FMLA, University Accommodation Letters, Disability Forms, Etc. (More than 2 Pages)
$50.00No
Records Request (by established patients)

One Week Service
$25.00 + $.25 per page over 10 pagesNo
Records Request (by established patients)

1 to 2 Day Service
$35.00 + $.25 per page over 10 pagesNo
GeneSight Testing (for non-established patients)$50.00No
Qb Testing (for established patients)$150.00Yes
Qb Testing (for non-established patients)$200.00Yes
Rx Request

Medication changes/refills outside of normal appointment times or due to missed appointments
$25.00No

Established patients are defined as currently being seen by an Axon Health Associates (AHA) provider. Non-established patients are not currently a patient at AHA

Please Note: The fee schedule listed above is by no means a comprehensive list.

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