FMLA/Disability Requests

Patient Instructions for FMLA/Disability Requests

Dallas Neurosurgical & Spine has partnered with HealthMark Group to ensure the accurate and timely completion of your FMLA and/or Disability forms.


Requests may be submitted electronically to HealthMark’s Request Manager at Once logged in, select “Submit Request” from the menu options and enter all required fields to submit a valid authorization. Each form requested for completion will require a $35 fee to be paid directly to HealthMark. Estimated turnaround time will be 48-72 hours.
If an email is provided, you will receive a response directly from HealthMark notifying you of the prepayment invoice. After payment, the completed forms may be downloaded directly through HealthMark’s website, or provided directly to you through an agreed to delivery method (i.e. secure email, mail, etc.).

Any questions?

Please log in to Request Manager for status updates or to chat with support. If you have any questions, you may contact HealthMark at 972-895-2138 or email

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