Costs for Uninsured Services
Please note that individual physicians reserve the right to adjust or waive fees at their discretion.
Fees are determined based on suggested rates per the Ontario Medical Association, derived from hourly rates and equivalent fees from Ontario’s schedule of benefits.
Uninsured Services
Notes, Forms, and CertificatesSick Notes, Back to Work Notes $40
Insurance Notes for Massage, Physiotherapy, Chiropractor, etc. $40
Attending Physician’s Statement Forms $175
Sickness & Accident Forms (short term only) $120
Functional Ability Forms $100
Disability Tax Credit Application $175
Camp and School Physical Forms $70
Pre-employment Certificate of Fitness $100
School or Work Forms to Verify Immunization Status $75
Travel Insurance Cancellation Form $175
Retirement Home Admission Forms $175
Retirement Home Medication Reviews $100
Life Insurance Death Certificate $100
Special Authorization for Drug Coverage Form (non-ODB, private insurance) $100
Medical Certificate for EI Compassionate Care Benefits $75
Children’s Aid Society Application for Prospective Parents $150
Guarantor Documents (i.e., for passports, birth certificates) $100
Letter for Exclusion from Jury Duty $100
EI Disability or Maternity Certificate $75
Canada AutoAbility Physicians Form (P2220) $70
CPP Narrative Medical Report $150 ($235 minus the $85 Service Canada Stipend)
Other Simple Forms not Otherwise Specified $50 / 5 minute increment
Diagnosis, Counseling, and Treatment
Prescription Renewal Without a Visit $25
Travel Medicine Advice or Consultation $200
Administration of Vaccinations for Immunizations not covered under OHIP $30 each
Ear Flushing (when not covered by OHIP) $50
Administrative Services
Photocopying / Printing / Faxing of Chart Notes (at patient’s Request) First 20 pages: $30 Each page after: $0.25
$52 per 15 minutes review
Emailing of Chart Notes (at Patient’s Request) $20
Missed Appointment Fee (without 24 hours’ notice) $50
Rebooking of Missed Specialist or Test Appointment $45
Replacement of Immunization Certificate $35
Replacement of Lost/Misplaced Prescription, Requisition for Tests $30
Transfer of Medical Records (on CD/PDF, electronic) (includes time for chart review) $100 flat rate
Administrative Fee for having to Mail/Send Reminders For Overdue Invoices $10
Driver’s Medical Services
Driver’s Medical Examination and Form $175
Driver’s Medical Follow-up Assessments (i.e., Diabetes, Cardiovascular, etc.) $150 each
Medico-Legal Letters, Complex Forms and Other Special Correspondence $50 / 5 minute increment
Liquid Nitrogen for Cosmetic Spots not covered by OHIP – up to 4 spots $30 per treatment
Liquid Nitrogen for Cosmetic Spots not covered by OHIP – 5 or more spots $80 per treatment
Simple Cosmetic Skin Spot Shave or Punch Removal $200