So far, everything's been really smooth. I chatted with someone on the site, then waited to speak with a doctor on the phone, and then submitted the payment. Now I just have to receive the actual letter in my email. Update: it's been 8 days since I did this, but I did receive the physical letter yesterday that had a gold seal on it compared to the pdf one I printed out myself on the day of. I'm satisfied that the process was easy and relatively quickly.