Wilmington Health Forms Policy

Wilmington Health charges set fees for completion of forms. This includes forms dropped off or faxed for completion. Certain forms may be excluded if completed during a medical appointment for that express purpose or if they meet exclusion criteria. 

  • $20 for a short and easy-to-fill-out form 
  • $40 for long and/or complex form 
  • Multiple forms will incur multiple charges.

Examples of forms that will incur charges:

  • FMLA forms
  • Disability forms
  • Other School forms (see below for exceptions)
  • Sports, work, or other Physical forms when not at WCV, CPE, or Sports Physical
  • Insurance forms (Accident, other coverage like Aflac)
  • Back to work forms (not notes)
  • Spousal/Family FMLA
  • Coast Guard forms
  • Foster/Adoption forms
  • Long-term care funds access forms
  • VA funds/services access forms

Examples of forms that will not incur a charge, unless they are labor intensive in any manner:

  • Medicaid Forms
  • Any form completed as part of a visit (i.e. CPE work form during a CPE visit, sports form during a Sports Physical, etc.).
  • Transportation
  • Handicap Accessibility Requests
  • School Required Medication Administration Forms
  • Kindergarten Required Forms
  • Return to Work/School Notes
  • Pharmacy Patient Assistance/Prior Authorizations
  • Asthma Action Plans

Wilmington Health will do our best to complete all forms within 5 business days of receiving the forms. If there are reasons the form is unable to be completed in five business days, we will advise the patient accordingly and set the best expectation for completion.