| Prescription renewal without an appointment. | $25 | |||
| Illness & returns to work notes | $25 | Revenue Canada Disability form | $40 | |
| Patient /insurance company requested notes for: physiotherapy, chiropractor, massage therapy, orthotics etc. | $25 | Daycare notes | $25 | |
| School/camp forms | $25 | Fitness Club Form | $40 | |
| Medical assessments: (when not covered by OHIP) Major Intermediate Minor |
$170.00 $75.00 $50.00 |
MOT Driver’s Medical Exam & form completion Examination Form |
$ 60 |
|
| Administration of vaccine (when uninsured) | $20 | Jury Duty Letter | $25 | |
| Attending Physician Statement | $145 | Forms required for volunteer work | n/c | |
| Disease specific questionnaire | $100-$200 | Liquid Nitrogen treatments (when not covered by OHIP) |
$25 | |
| Veterans Affairs paperwork | $100-$200 | TB Test (when required by work/school) 1-step ($30 with paperwork) 2-step ($40 with paperwork) |
$10 $20 |
|
| Certificate of Medical Status | $25 | Letters on behalf of patients (depends on time & work involved) |
varies | |
| Chart transfers (not including MD chart review) (if > 20 pages, additional pages/photocopies plus shipping & postage) |
$30.00 | Pre-employment certificate of fitness (ie: Parmalat) |
$100 | |
| Private insurance forms (depending on time & work involved) |
$100+ | Children’s Aid Society forms Pre-adoption exam Application for prospective parent |
$220 $40 |
|
| Travel consult Single Family |
$60 $80 |
Auto accident insurance forms (OCF) (depending on time) |
$100-$140 | |
| Travel cancellation forms | $50 | Legal reports (depending on time) |
$100-$250 | |
| Disability Tax credit certificate (clarification report) |
$75 $50 |
Other insurance/disability forms (OMA rates) |
varies | |
| Cortisone injection (using our supply) |
$25 |
- fees updated January 2021
