Records Request
The following rates apply for record requests:

30 Days Notice (First Copy): No charge
30 Days Notice Second Annual Copy: $15
Less than 30 Days Notice: $30 fee
Less than 14 Days Notice: $45 fee
7 or Less Days Notice: $60
Custom Letter: $100/hr, $50 minimum fee
Certified Records: $50

Signed release for records can be emailed to records@creativecounselingandconsultation.com

We do not have records for JP Interventions and are unable to assist in obtaining these.
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Name of client *
Client date of birth *
MM
/
DD
/
YYYY
Client phone number *
Person requesting records *
Agency *
Relationship to client *
Your phone number *
Your email address *
Reason for request *
Date records are needed by *
Do you have a preference in how records are transmitted? *
Based on your choice above, please provide us with the appropriate information (Fax Number, Email address) *
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