top of page

FMLA  Form Request

CRC is happy to complete your paperwork such as FMLA, disability, return to work, etc.  Please note that all requests must be paid prior to being completed and cannot be completed until the patient has had the procedure. Please leave your paperwork with the patient and/or employer portion filled out. Patients have ONLY 2 options on how to submit these forms.  

  • You may delivered the required paperwork, in person, to our Downtown office located at 110 W. Underwood St. for drop off. Your payment is due at the time of drop off for processing.  

  • You may email your paperwork to Before doing so you will need to call the billing department to make your payment and attach your paid receipt to that email as proof of payment for processing.  

Attention: We no longer process FMLA paperwork via FAX.

Our processing fees are listed below:

Time to Process

Our triage department will complete these forms, and submit your paperwork to the designated party.

The paperwork is available for download/printing by clicking here, or by clicking the PDF button, below.

If you have any questions, please contact the Triage Dept. at extension 3014.

bottom of page