Accommodation Letters, Assessment & Documentation

At StorieBrook, we work with a lot of clients who are navigating neurodiversity, disability, chronic illness, and other experiences that may call for formal documentation — whether that's a letter supporting a workplace accommodation request, academic support services, housing modifications, or gender-affirming medical care.

We want to be clear about two things upfront: we are always here to support you, and we want that support to be as meaningful and well-grounded as possible. The guidance below explains how we approach documentation requests and what we'll need from you to do that well.

We support you — and we want that support to count.

When a clinician writes a letter on your behalf, that letter carries their professional license and credibility. It also carries our collective commitment to you. We take that seriously — not as a gatekeeping measure, but because letters that are grounded in a real clinical relationship and supported by documentation are far more likely to actually get you what you need.

A letter written without sufficient context or supporting history is not only less persuasive — in some cases it can be actively unhelpful, or create complications with the requesting institution. Our goal is always to advocate for you effectively.

What we can write letters for

Our clinicians are able to write clinical support letters for:

•       Workplace accommodations — supporting ADA accommodation requests, modified duties, flexible scheduling, remote work, sensory modifications, or other employer-required documentation.

•       Academic accommodations — supporting requests to disability services offices, 504 plans, or extended time, reduced distraction environments, and other academic supports.

•       Housing accommodations — supporting requests for service animals, housing modifications, or other needs covered under fair housing protections.

•       Gender-affirming medical care — supporting access to hormone therapy, surgical procedures, or other gender-affirming interventions, in accordance with WPATH Standards of Care.

We cannot write letters for legal proceedings, court involvement, or any purpose not listed above. If you have a need not covered here, please talk with your clinician and we will do our best to point you toward the right resource.

What we need from you

1. An established clinical relationship

We require a minimum of eight sessions before a clinician can write a letter on your behalf. This is not about bureaucracy — it's about your clinician having enough genuine, firsthand knowledge of your experience to advocate for you credibly and accurately.

If your need is time-sensitive, please talk with your clinician as early as possible. We will always do our best to work with you.

2. Prior assessment or diagnostic documentation

For accommodation letters — particularly for neurodivergence, disability, or chronic illness — we will ask you to provide documentation of any prior assessment or diagnosis from another provider. This might include:

•       A psychological or neuropsychological evaluation

•       A written diagnosis from a physician, psychiatrist, or other licensed provider

•       Prior school or workplace assessment records

•       Any other formal documentation of your diagnosis or functional needs

You do not need a formal diagnosis to work with us — many of our clients are in the process of exploring or seeking one, and that is completely valid. But to write a letter that asserts a specific diagnosis or functional impairment to a third party (an employer, school, housing authority, or medical provider), we need to be working from documented clinical information, not from our sessions alone.

If you don't have prior documentation, your clinician can help you think through options — including whether a referral for formal testing might be a useful next step. We can support that process alongside you.

Gender-affirming care letters

We are committed to affirming, compassionate care for transgender, non-binary, and gender-diverse clients. Letters supporting gender-affirming medical care are something we take seriously and approach with care — for you, and for the clinical and ethical standards that protect this work long-term.

All gender-affirming care letters at StorieBrook are written following the WPATH (World Professional Association for Transgender Health) Standards of Care and our informed consent model. This means:

•       Your clinician will work with you collaboratively, not as a gatekeeper

•       The process centers your own understanding of your identity and your needs

•       All letters are reviewed and signed off by Dr. Kieran before being issued

The same eight-session minimum applies. We know that access to gender-affirming care is urgent for many clients, and we will always work as efficiently as we can within these standards.

Fees for documentation

Writing clinical letters and documentation takes professional time outside of your regular sessions, and we charge a flat fee for this work:

 •       Simple or verification letters (e.g., confirming you are a current client, basic employer verification): $50

•       Standard accommodation letters (workplace, academic, or housing): $100

•       Gender-affirming care letters: $150, reflecting the additional drafting time, Dr. Kieran's review, and WPATH documentation requirements

Your clinician will always confirm the fee with you before beginning any letter, so there are no surprises. Letter fees are separate from your session fee and are not covered by insurance.

If you are on our sliding fee scale or low-cost therapy program, or if cost is a barrier for any reason, please let your clinician know. Letter fees can be reduced on a case-by-case basis — we never want the cost of documentation to stand between you and the support you need.

Questions?

If you have questions about this process, or want to start a conversation about a documentation need, please bring it up with your clinician at any time. You can also reach our admin team at admin@storiebrook.com.

We are always on your side — and we want the letters we write to reflect that.