a. Original card................ |
No Fee |
b. Renewal card................. |
No Fee |
c. Corrected card................ |
No Fee |
d. Duplicate card................ |
No Fee |
e. Certified copy with seal......... |
$5 |
f. Search..................... |
$2 |
g. Applicant with a disability........ |
No Fee |
h. Authorized release of medical information to public agency,
governmental body, or locally operated program performing services for a public agency or governmental body. |
No Fee |
i. Authorized release of medical information to public agency,
governmental body, or locally operated program performing services for a public agency or governmental body in certified form with seal. |
No Fee |
j. Authorized release of a cardholder's medical information to that same |
|
cardholder....................... |
50¢ per page |
k. Authorized release of a cardholder's medical information to that same cardholder in certified form with seal. |
50¢ per page, |
|
plus $2.00 |
|
certification. |