Sharecare is a health information management company contracted with OBGYN Medical Center Associates to provide services, including the completion of Disability and FMLA form paperwork.

There are several ways to get information to Sharecare:

• Return the form to the practice where you are seen
• Fax form to 713-512-7094
• Click here to complete the Authorization/Form Completion Request and upload your blank form
• Scan the QR Code ->

Yes, there is a fee of $25 for all forms, plus any applicable sales tax.

Yes, a fee of $25 per form plus any applicable sales tax for each consecutive orsubsequent FMLA or Disability form regarding the same qualifying condition and claim.

There are various ways to pay for your form:

Pay Online:

• Suppose you have provided a valid email address on your authorization form. In that case, you will receive an email notification with a payment link that will direct you to pay on the Sharecare payment portal website.
• If you did not provide an email address on your authorization form or cannot locate the email notification, you could pay online at payonline.hds.sharecare.com. You will need your Request ID to make the payment.

Pay by Phone:

• Contact the Sharecare Forms Department at 866-273-4039. We like to make it as easy and convenient as possible for you. We accept all major credit cards. We do not accept HSA cards as a payment method.

A Request ID is a unique ID specific to the individual patient and form being completed. Sharecare assigns the ID, and if you are unable to locate it, you can contact Sharecare for assistance at 866- 273-4039.

Yes, we would like all the patients to fill out a Request for Form Completion document when requesting a form to be completed. This document provides the team with information on where and how to send the form. Also, if a disability insurance company calls, we cannot give any information without consent, thus delaying your claim with your disability company. In addition, this document asksfor the patient to identify the treating provider, injury/problem date, and last day worked, which will aid in completing your form.

You can contact the Sharecare Forms Department at 866-273-4039 for the status of your form, as well as the Request ID number associated with your form.

We understand that FMLA forms, as well as disability determinations, may require an update of your medical information from your recent doctors' visit. You will need to re-submit the new paperwork to OBGYN Medical Center Associates for Sharecare to complete in such cases. There will be a fee of $25.00 required for any updates requested.

Please allow 48 hours for Sharecare to receive your form from the time you submit it to OBGYN Medical Center Associates. Once payment isreceived, it may take up to 3-5 business days to deliver the completed form(s). It is imperative to submit all information and make the pre- payment as soon as possible; failure to do so will delay the process.

You can contact the Sharecare Forms Department at 866-273-4039 for assistance.

Please reach out to our team at Sharecare, and we are happy to discuss any questions you might have. Contact us at 866-273-4039.