| Missed well-child or ADHD recheck visit (no-show) |
$25 |
Does not apply to Medicaid or CHIP patients |
| Your first copy of your child's medical record |
Free |
Also free when records go to your new doctor |
| Extra copies of the medical record |
Up to $25 |
First 20 pages, then $0.50 per page - never more than Texas and federal law allow |
| Vaccine record (paper copy after your visit) |
$5 |
Always free on the patient portal |
| School, camp, or sports forms after your visit |
$10 |
Free if you bring them to the visit |
| Rush fee (form needed in 2 days or less) |
$10 |
Normal turnaround is 5-7 days |
| Sports Physical |
$60 |
Does not apply Medicaid or CHIP patients |
| FMLA (Family and Medical Leave Act) |
$25 |
Allow 5-7 days |
| Late Payment fee |
$25 |
Added after the 2nd unpaid billing notice |
| Returned check |
$40 |
For checks returned for insufficient funds |
