COSTS:

COSTS: A. Estimates as to cost will be made upon request. B. Fees charged will be according to the following schedule: 1. Twenty Dollars ($20.00) for pages one (1) through twenty (20); 2. One Dollar ($1.00) per page for the next eighty (80) pages; 3. Fifty Cents (50¢) per page for all pages thereafter. 4. Ten percent (10%) of the total charge may be added for postage and handling. 5. Fifteen Dollars ($15.00) may be recovered by the program or DMH for retrieving medical records in archives at a location off the premises where the program or DMH Central Office is located. 6. No program shall charge no more than Twenty-five Dollars ($25.00) for executing a medical record affidavit, when the affidavit is requested by the individual or their representative. C. Requested information will not be released until fees are paid.