Additional Services
Uninsured Service Fee Schedule
All uninsured service fees are listed below. Scroll to see the complete list.
| Service | Cost |
|---|---|
| Charges for Reproduction/Transmission of Medical Records - Electronic | $30 |
| Paper Copy Request | $30 (first 20 pages) + $0.25/page thereafter |
| Physician Review per 15 minutes | $45 |
| Schools, camps, pre-school, daycare and university forms for physicals | $35.00 |
| Pre-employment certification of fitness/gym clubs or hospital/nursing home employees | $45.00 |
| Back to work note, sick note or daycare note (free of communicable disease) | $30.00 |
| CRA Disability Tax Credit Certificate (T2201) | $150.00 |
| Insurance Certificate OCF-3 Disability Certificate | $164.00 |
| Insurance Certificate OCF-18 Treatment Plan | $164.00 |
| OCF-19 Determination of Catastrophic Impairment | $136.00 |
| Insurance Certificate OCF-23 Treatment Confirmation | $163.00 |
| Attending Physician's Statement (2+ pages) | $160.00 |
| Attending Physician's Statement Short Form (1-2 pages) | $80.00 |
| Insurance Medical Examination (assessment and report) | Physician's hourly rate |
| Medical Report for CPP Disability Benefit (SCISP-2519) | $85 to Gov.; $45 patient pay |
| CPP Narrative Medical Report | $150.00 |
| Driver's medical examination form (FORM ONLY) | $67.00 |
| Driver's medical examination with form | $286.60 |
| Civil aviation medical examination report 26-0010E (001004) | Physician's hourly rate |
| Children's Aid Society (CAS) application for prospective foster parent | $67.00 |
| INS5140 - Medical certificate employment insurance sickness benefits | $45.00 |
| Travel cancellation insurance form | $44.00 |
| Life insurance death certificate | Physician's hourly rate |
| Medical certificate for employment insurance compassionate care benefits | $64.00 |
| Other simple forms not otherwise listed | $45.00 |
| Attending Physician's Statement (Life & Health Insurance Reports) | Physician's hourly rate (min $160) |
| System-Specific or Disease Specific Questionnaire | $110.00 |
| System-Specific Examination | $133.00 |
| Insurance Medical Examination | Physician's hourly rate |
| Clarification Report | $440.00/hour |
| Full Narrative Report | $440.00/hour |
| Independent Medical Examination | Physician's hourly rate |
| Missed Appointment / <24 hours notice | $40.00 |
| Immunizations not covered by OHIP - Injection Only | $30.00 |
| Ear Flush (when not medically necessary) | $50.00 |
| Liquid Nitrogen (when not medically necessary) | $25 per treatment |
| Physio/Chiro/Massage/Orth. | $30.00 |
| Replacement Immunization Card | $25.00 |
| Application for Accessible Parking Permit | $0 (No Charge) |
| Accessible Transit Eligibility Application forms | $0 (No Charge) |
| Ministry of Health Forms (e.g., Assistive Devices, etc.) | $0 (No Charge) |
| Canadian Passport Application - physicians do not act as guarantors | $0 (No Charge) |
Website translations are provided for convenience. Clinic services are offered in English.