Third-Party & Other Uninsured Services
Fee Schedule
As per Ontario Medical Association Guidelines:
| Notes | |
|
Medical Notes
(ie. Return to Work, Orthotics, Chiropractor)
|
$10.00 - $20.00 |
|
|
|
|
Forms
|
|
| Driver’s Physical and Form | $100.00 |
| -Supplementary Forms from Driver's Physical | $30.00 |
|
*Insurance Forms (guideline only and is at the discretion of the physician based on complexity of form) |
$20.00 - $50.00 |
| Travel Cancellation/Insurance Forms | $40.00 |
| Medical Certificate/Report | $20.00 - $50.00 |
| Elective Pre-operative | $30.00 |
|
|
|
| Treatment | |
| Cryotherapy - Liquid Nitrogen | |
| Per treatment of wart removal | $10.00 |
| Travel Medications | $10.00 |
|
|
|
| Medical Records – Patient Request | |
|
1-5 pages
|
$10.00 |
| 6-10 pages | $20.00 |
| 11-20 pages | $35.00 |
|
Each additional page
|
$0.30 |
| CD's - Flat Rate | $50.00 |
|
Postage costs responsibility of patient
(includes postage & registered mail)
|
$14.00 |
| *This is a guideline only and is at the discretion of the physician. | |
Please pay by cash at Front Office.
