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. |