They have automated phone service so you do not get a human, they string you along with emails, no re riot for your purchase. They promise a therapist from your state will do the letter yet mine came from Tennessee not my home state. I cancelled by phone message and emails to two people, then suddenly, 7 days later I get the PDF by email and another charge on my account. Do not waste your time and money. I called my own physician and got the letter needed. Their site is misleading... do not do business with this scam. They say you need a mental health therapist, not true, a physicians letter is perfectly acceptab