Gloucester Family Health Centre
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Fees for Uninsured Services
(Services not covered by OHIP)

Forms & Notes


Schools/Camps - $30
Admission to day-care, preschool, university or any educational institution - $30
Pre-employment Certification of Fitness/Fitness Clubs - $40
Government Pension buyback physical and form - $250
Hospital/Nursing Home Employees - $40
Back to Work Notes/Sick Notes - $25
Day Care Note (free of communicable disease) - $25
Employee absentee form - $40
Student/Employee proof of immunity form - $40
Referral Note for massage therapy, orthotics, back support, stockings etc. - $10/each

Copies from the Patient’s Chart


Printing/Faxing - Up to 20 pages - $1/pg.
Printing/Faxing - Over 20 pages - $30 + $0.25/pg.
Copying to a USB Drive - $60​

Medical Services and Other Services


Ear Syringing - $25
One Step TB Test  (Not covered by OHIP: for employment/volunteer purposes) - $60
Two Step TB Test  (Not covered by OHIP: for employment/volunteer purposes) - $70
Uninsured vaccine injection fee - $20/injection

Missed Appointment - $50
Same Day Cancellation - $25
Missed Period Health Exam - $80
Immunization record placement - $40

For a Comprehensive List of Uninsured Services

Comprehensive List of Uninsured Services
File Size: 250 kb
File Type: pdf
Download File

  • Home
  • Clinic Hours
  • Appointments
  • Patient Enrollment
  • Contact
  • Fees for Uninsured Services
  • Privacy Policy
  • Feedback Form