FMLA/Disability Forms

 
 
 
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MaxHealth Family, Internal & Sports Medicine outsources the FMLA/disability form completion process to HealthMark Group. HealthMark Group will complete FMLA and/or disability forms upon receipt of the requested forms and valid authorization. The estimated turnaround time for completion is 24-72 hours.

Applying for FMLA or disability benefits can be overwhelming, but MaxHealth Family, Internal & Sports Medicine is here to help. Below, we’ve outlined the steps for submitting your request. If you need additional help, you can call 972-895-2138 or email fmla@healthmark-group.com.

How to Submit Your FMLA or Disability Request

  1. Email your request to clinicalforms@healthmark-group.com.

  2. Include the following details in the email body:

    • Your full name and date of birth

    • Your doctor’s name

    • Your healthcare facility’s name, address, and phone number

  3. Attach all necessary forms related to your request.

Don’t have your forms yet? No problem. Here’s how to get them:

  • Request forms electronically through HealthMark’s Request Manager at https://requestmanager.healthmark-group.com.

  • Once logged in, select “Submit Request” and enter the required information to complete a valid authorization.

  • Note: There is a $35 processing fee for FMLA and disability forms, payable directly to HealthMark before processing begins.

After submitting, you’ll receive a prepayment invoice (if an email is provided). Once payment is made, completed forms can be downloaded from Request Manager or sent to you through your preferred method (secure email, mail, etc.).

Processing Time

Most FMLA or disability requests are processed within seven days. We understand that waiting can be tough, so please know we are actively coordinating with your provider, insurance company, employer, and you. If there are any delays, we’ll keep you informed every step of the way.

For more information, visit our FAQ page.

For additional assistance, check your request status or chat with support by logging into Request Manager. You can also reach HealthMark directly at 972-895-2138 or email fmla@healthmark-group.com.