Third-Party Fees

  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


$120

$ 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
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