I am an active patient at EKM Psychiatry with an established treatment history at this practice.*

I understand that submission of this request does not guarantee that a letter will be issued.*

I understand the fee is due before work begins and is non-refundable once the letter has been drafted.*

I understand EKM Psychiatry cannot guarantee acceptance of this letter by any specific landlord or housing provider.*

I have read and agree to EKM Psychiatry's documentation request policy.*