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Professional Medical Evaluations, Forms & Documentation
Proficient Health & Wellness provides professional medical evaluations and documentation services for patients needing support with employment, disability, surgery-related requirements, injury documentation, and other healthcare-related forms. Each evaluation is based on the provider’s clinical findings, medical necessity, and professional judgment.
Employment & Workplace Evaluations
Employment & Workplace Evaluations
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Return-to-Work Evaluations Evaluation after illness, injury, or medical leave to determine readiness to safely return to work.
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Fitness-for-Duty Evaluations Assessment of an individual’s ability to safely perform essential job duties.
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Work Restriction Evaluations Documentation of temporary or ongoing work limitations, when medically appropriate.
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Employment Physicals Physical exams required by employers, schools, or organizations.
Disability & Leave Documentation
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FMLA Documentation Review Review and completion of medical documentation for FMLA leave requests.
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Short-Term Disability Evaluations Medical evaluations and supporting documentation for short-term disability claims.
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Long-Term Disability Evaluations Comprehensive medical evaluations and documentation for long-term disability requests.
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Medical Accommodation Documentation Medical evaluations and documentation to support workplace accommodation requests when clinically appropriate.
Surgical & Medical Evaluations
Perioperative Risk Assessment
Medical evaluation before a planned procedure to assess overall health and identify potential risks.
Add this notice under that section:
Additional testing may be required depending on the patient’s medical history and surgical requirements. EKGs and specialty testing are performed by outside providers. Outside testing fees are not included in the visit fee
Injury Documentation Services
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Motor Vehicle Accident Evaluations Medical evaluations and documentation following automobile accidents.
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Personal Injury Evaluations Medical evaluations and documentation for injuries related to accidents, falls, or other incidents.
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Injury Follow-Up Visits Follow-up visits to assess healing progress, symptoms, and any ongoing limitations or restrictions.
Service Pricing
Return-to-Work Evaluation
$75
Short-Term Disability Evaluation
$150
Personal Injury Evaluation
$250
Work Restriction Evaluation
$100
Long-Term Disability Evaluation
$250
Additional
Forms
$50/each
Fitness-for-Duty Evaluation
$150
Perioperative Risk Assessment
$275
Rush
Processing
$100
FMLA Documentation Review
$150
Auto Accident Evaluation
$250
Prices listed are starting fees. Additional fees may apply for complex forms, additional documentation, record review, outside testing, or extended provider time.
Important Information
Completion of medical forms, evaluations, or reports does not guarantee approval of leave requests, disability benefits, workers’ compensation claims, insurance claims, employment accommodations, surgery approval, or legal matters. All recommendations are based solely on the provider’s independent medical assessment, available records, and professional judgment.