MEDICAL EXAMS |
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| Basic Visit (no or invalid OHIP) weekdays | $75.00 | ||||||
| Basic Visit (no or invalid OHIP) evenings or holidays | $95.00 | ||||||
| Driver’s medical examination (form not included) | $125.00 | ||||||
| Physical Examination Required by Third Party | $140.00 | ||||||
| Major Visit/Adult Physical | $140.00 | ||||||
| Child Annual/Camp Physical | $80.00 | ||||||
| Travel Advice | $50.00 | ||||||
| Ear Syringing (when not qualifying for OHIP) | $30.00 | ||||||
| Cosmetic minor surgical procedures | $50.00 and up | ||||||
| PAP Test | $60.00 | ||||||
FORMS/NOTES |
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| Sick Note | $25.00 | ||||||
| Back-to-Work Note | $25.00 | ||||||
| Massage Therapy, Orthotics, Physio, Compressing Stockings, etc. | $25.00 | ||||||
| Day Care Note (Free of Communicable Disease) | $25.00 | ||||||
| School, Camp Physical (Form only) | $45.00 | ||||||
| Driver’s Medical Exam (MOT, FLRC80 Form Completion only) | $60.00 | ||||||
| Driver’s Medical Exam (MOT, FLRC80 Form + Physical exam) | $185.00 | ||||||
| Pre-Employment Certificate of Fitness | $40.00 | ||||||
| Lost Prescriptions / Referral Notes | $20.00 | ||||||
| Prescription by Fax / Phone | $20.00 | ||||||
| Ontario Accessible Parking Permit (For People with Disability) | $30.00 | ||||||
| Fitness Club Form | $45.00 | ||||||
| Letter on Behalf of Patient | Hourly Rate | ||||||
| Certificate of Medical Status | $25.00 | ||||||
| Children’s Aid Society Application for Prospective Foster Parent | $55.00 | ||||||
GOVERNMENT FORMS |
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| CPP Disability Medical Report Form | $85.00 | ||||||
| EI Disability/Maternity Report | $40.00 | ||||||
| Revenue Canada/Federal Disability Tax Credit | $100.00 | ||||||
| Employment Insurance – Maternity Certificate | $30.00 | ||||||
| Medical Report-Canadian Immigrants | $100.00 | ||||||
INSURANCE |
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| Private Insurance Sickness and Disability – Short Term | $125.00 | ||||||
| Private Insurance Sickness and Disability – Long Term | $150.00 | ||||||
| Attending Physician’s Statement | $150.00 | ||||||
| Life Insurance Death Certificate | $45.00 | ||||||
| Travel Cancellation Form | $100.00 | ||||||
| Medical Certificate for EI Compassionate Care Benefits | $45.00 | ||||||
| OCF-18 Treatment plan | $140.00 | ||||||
| OCF-3 Disability certificate | $140.00 | ||||||
| OCF-19 Determination of catastrofic imparement | $130.00 | ||||||
| OCF-23 Treatment confirmation | $140.00 | ||||||
| System or Disease Specific Questionnaire | $90.00 | ||||||
| System Specific Examination | $110.00 | ||||||
| General Questionnaire | $50.00 | ||||||
| Other Insurance Forms | Hourly Rate | ||||||
| Clarification Report | Hourly Rate | ||||||
| Full Narrative Report | Hourly Rate | ||||||
| Insurance Medical Examination | $225.00 | ||||||
LEGAL |
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| Jury Duty Letter | $25.00 | ||||||
| Lawyer’s Letters | Hourly Rate | ||||||
| Medical Report Requested by a Law Firm | Hourly Rate | ||||||
IMMUNIZATIONS |
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| Injections needed for Travel | |||||||
| (HEP A, HEP B, Twinrix, HPV/Gardisil, Menactra,Zostavax/Shingles,Thyphrix,Avaxim) | $20.00 | ||||||
| TB Mantoux One Step Test | $50.00 | ||||||
| TB Mantoux Two Step Test | $70.00 | ||||||
PROCEDURES |
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| Wart-cryotherapy (first wart) | $30.00 | ||||||
| Each additional wart | $15.00 | ||||||
| Seborrheic Keratosis | $40.00 | ||||||
| Skin Tags Removal and other cosmetic procedures | $50.00-$200.00 | ||||||
| Excision & Suture of Moles, Cysts, Lipomas (first lesion) | $80.00 | ||||||
| Each additional | $30.00 | ||||||
OFFICE/ADMINISTRATIVE |
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| Missed Appointment without 24h notice | $35.00 | ||||||
| Missed Physical Examination | $70.00 | ||||||
| Transfer of Medical Records | |||||||
| First 1-5 pages | $30.00 | ||||||
| Each Page After 5 | $1.00 | ||||||
| CD or USB – Individual or family | $50.00 | ||||||
| Prescription Renewal without Appointment (when Appropriate) | $20.00 |
Notes:
- Disability tax credit form – Filling the form does not ensure qualification for the program
- Prescription renewals will be provided by Fax or Phone only when appropriate and at the request of the patient or patient representative only
- Fees for Letters on behalf of the patient will be provided when appropriate and the fee depends on the work required
Uninsured Services Clarification:
- Prescription renewals are not covered by OHIP when provided without a visit
- Forms and certificates are uninsured when they are provided at the request of the patient and are transmitted to a third party such as an employer, private insurer, and others
- TB skin test is uninsured when requested by the patient and/or is not medically necessary
- Faxing & photocopying is uninsured when it is provided for the patient’s personal use or for a third party
- Referral notes are uninsured when the note is requested by the patient to obtain services that are not medically necessary
- Removal or treatment of warts is insured by OHIP only for plantar warts, genital warts and all warts in immunocompromised patients