Uninsured Services
FEES FOR PATIENT FORMS, LETTERS AND PROCEDURES AS MENTIONED BELOW, ARE NOT COVERED BY OHIP, AND ARE THE PAYMENT RESPONSIBILTY OF THE PATIENT.
| Missed Appointments | Cost | ||
| Missed Appointment - Regular appointment | $30.00 | ||
| Missed Appointment - Periodic Health Exam, counselling, or procedural | $60.00 | ||
| Clinical Services | |||
| TB Skin Test | $20.00 | ||
| Liquid nitrogen treatment (OHIP covers feet and genital removals) | $20.00 | ||
| Pregnancy Test | $25.00 | ||
| Ear syringing, not meeting OHIP guidelines | $25.00 | ||
| Removal of lesions (moles/cysts/skin tags) | $50 - $200 | ||
| Insurance Medical Examination | $200.00 | ||
| Travel advice | Please refer to Travel Clinic unless short advice for ordering of meds etc. | ||
| Forms | Cost | Appointment Required | |
| Physicals | |||
| School/camp | $30.00 | ||
| Pre-employment | $35.00 | √ | |
| Fitness Club | $35.00 | √ | |
| Hospital/Nursing Home Employee | $35.00 | √ | |
| Licensing Forms | |||
| Drivers Medical Exam (FLRC80): must add exam cost on this | $50.00 | √ | |
| Third Party Physical exam is separate and non ohip covered | $130 ($180 total with form above) | √ | |
| Employment Work/School Forms/Notes | |||
| Back to Work | $20.00 | √ | |
| Immunization records (depending on time spent searching for results and length of form) | Range $ 20 to $40 | ||
| Sick Notes/Day Care | $20.00 | √ | |
| Employment physical and form | $140.00 | √ | |
| Fed Employee Absence Note (Blue) | $20.00 | √ | |
| Insurance Certificates | |||
| Treatment Plan (OCF-18) | $140.00 | √ | |
| Disability Form (OCF-3) | $140.00 | √ | |
| Determination of Catastrophic Impairment (OCF-19) | $120.00 | ||
| Treatment Confirmation (OCF-23) | $140.00 | ||
| Travel Cancellation | $40.00 | √ | |
| Disease/System Specific Questionnaire | $80.00 | √ | |
| UIC Disability/Maternity Certificate | $30.00 | √ | |
| Insurance medical examination (assessment and report) | $235.00 | √ | |
| APS (Attending Physician’s Statement) | $145.00 | √ | |
| Government Forms | |||
| CPP Disability Medical Report (government copay $85) | $85.00 | √ | |
| CPP narrative medical report | $150.00 | ||
| Rev Canada, Fed Disability Tax Credit | $45.00 | √ | |
| Miscellaneous | |||
| Chart Transfer | $60 (includes encrypted CD cost) | ||
| Charges for Reproduction/Transmission of Medical Records (not to patient but to other party such as lawyer, insurance company, etc.) | |||
| (a) Copying/printing (or digital reproduction) | (a) $30 (first 20 pages) + $0.25 per page thereafter | ||
| (b) Out-of-pocket disbursements (were applicable) and copies from patient chart | (b) At cost b) $1.00 a page | ||
| (c) Physician review of records (where applicable) | (c) Physician's hourly rate, after first 15 minutes | ||
| ODSP | None | √ | |
| Handicap Parking | None | ||
| Hearing Aide | None | ||
| Updated October 16, 2019 | |||
Military Forms
Application Canadian Armed Forces $120.00
THERE ARE NO CHARGES FOR ANY OF THE FOLLOWING FORMS:
- Application for Accessible Parking Permit
- Transit form for the disabled
- Permanent resident card forms
- Request for birth certificate forms
- Children’s Aid Society Forms (on behalf of child)
-
Ministry of Health and Long-Term Care Forms
- (e.g. Limited Use, Assistive Devices)
Receipts for any services above can be issues for Income Tax Purposes.
Weblink Canada Revenue Agency link for eligible medical expenses below:
http://www.cra-arc.gc.ca/medical/#mdcl_xpns