Fees for Uninsured Services (Services not covered by OHIP)
Assessments
Minor Assessment (for Non-OHIP Patients or not covered by OHIP) .................................................................................................................................................................. $68.19 Intermediate Assessment (for Non-OHIP Patients or not covered by OHIP) .................................................................................................................................................................. $108.99 General Assessment (for Non-OHIP Patients or not covered by OHIP) .................................................................................................................................................................. $250.95 Annual Complete Physical Examination/General Physical Examination (GPE) (for OHIP Patients, not covered by OHIP) ......................................................................................... $186.30 Travel Consultation and Vaccine Administration (per person) (Vaccine cost not included) .............................................................................................................................................. $98.33 Hearing Assessment (By Hearing Instrument Specialist, Not covered by OHIP) ................................................................................................................................................................ $85.90
Procedures
IUD Insertion (By Nurse Practitioner, Not covered by OHIP) ................................................................................................................................................................ $85.90 IUD Removal (By Nurse Practitioner, Not covered by OHIP) ................................................................................................................................................................ $51.75 Nexplanon Insertion (By Nurse Practitioner, Not covered by OHIP) ................................................................................................................................................................ $85.90 Nexplanon Removal (By Nurse Practitioner, Not covered by OHIP) ................................................................................................................................................................ $51.75 One Step TB Test (for employment or volunteering purposes) .................................................................................................................................................................. $67.28 Two Step TB Test (for employment or volunteering purposes) .................................................................................................................................................................. $77.63 Uninsured vaccine injection (per injection) .................................................................................................................................................................. $31.05 Ear Syringing (per ear) .................................................................................................................................................................. $41.40
Forms, Letters and Notes
Referral Note for massage therapy, orthotics, back support, stockings etc. .................................................................................................................................................................. $19.67 Completion of documentation/forms for physicals for schools, camps, pre-school, daycare, university/educational institutions ............................................................................... $34.93 Completion of documentation/forms for physicals for pre-employment certification of fitness/fitness clubs or hospital/nursing home employee ................................................. $46.32 Sick notes (includes return to work/school notes), Certificate of freedom from communicable disease .......................................................................................................................... $31.05 Drivers’ medical examination (form only) .................................................................................................................................................................. $72.45 Drivers’ medical examination (Includes medical assessment, vision assessment and form) ............................................................................................................................................. $323.40 Children’s Aid Society (CAS) application for prospective foster parent (Examination and form) .................................................................................................................................. $238.05 Clarification Report/Full Narrative Report ........................................................................................................................................................... $455.00/hr CRA Disability Tax Credit Certificate (form T2201) ........................................................................................................................................................... Case based Life insurance death certificate ........................................................................................................................................................... Case based Civil aviation medical examination report 26-0010E (001004) ........................................................................................................................................................... Case based Attending Physician Statement ........................................................................................................................................................... Case based Any other form (not listed above) ........................................................................................................................................................... Case based
Administrative Fees
Printing/Transmission of Results/Reports (per result/report) ................................................................................................................................................................... $7.00 Release of Medical Records (Copying/printing/scanning) ....................................................................................... $31.05 (first 20 pages), thereafter $0.26 per page Release of Medical Records (Electronic transfer) .................................................................................................................................................................. $41.40 Physician review of records for release of medical records ............................................................................................................... $45 per 15 mins, after first 15 mins Immunization record replacement .................................................................................................................................................................. $41.40 No-show/missed regular appointment .................................................................................................................................................................. $72.45 No-show/missed annual health examination appointment .................................................................................................................................................................. $93.15 Same Day Cancellation (less than 24 hours) ................................................................................................................................................................. $31.05
Unremunerated Report Forms
Application for Accessible Parking Permit ......................................................................................................................................................... No charge Accessible Transit Eligibility Application forms ......................................................................................................................................................... No charge Children’s Aid Society Forms (on behalf of a child) .......................................................................................................................................................... No charge Canadian Passport Application .......................................................................................................................................................... No charge Ministry of Health Forms (e.g., Assistive Devices, etc.) .......................................................................................................................................................... No charge
Payment Modes
- Credit/Debit Card - E-transfer - [email protected] {Mention the patient’s name, physician’s name, and reason in the message} - Cash
