Midwest Disability & FMLA Forms
For Patients of: Southside OB/GYN, OB/GYN of Indiana, Seven Hills Women’s Health Center, or Lexington Women’s Health
Forms are $30 for the first form and $15 for each additional form turned in at the same time. After payment is received, Disability/FMLA forms are completed and sent to the requestor within three business days.
Turn in your form(s) to be completed via the following options:
- Email: A PDF of the form can be sent to [email protected]
- Fax: 888.972.2476
- Mail: MediCopy Attn: Form Completion Dept. 8 City Blvd. Suite 400, Nashville, TN 37209
- In-Person: Drop the blank Disability or FMLA form off at your doctor’s office.
Please include an intake form with your paperwork.
Learn more about MediCopy’s Form Completion service
If you have any questions, please contact MediCopy:
Online Chat: MediCopy.net | Phone: 866-587-6274 | Email: [email protected]