Request for Evaluations, Assessments, Letters, and Forms Completion

* If you will be requesting an evaluation, assessment, or letter issued by Cornwall Counseling, i.e., FMLA, LOA, court-ordered verification, court report, metal health examination, etc. Please provide the following information. Completing written documents is reimbursed at $120.00 per hour (one hour minimum)

Please complete this form, if you will be requesting any written documents, i.e., Leave of Absence, FMLA, Court Report, etc.

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