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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
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 - $30.00

Treatment
Cryotherapy - Liquid Nitrogen
Per treatment of wart removal $10.00

Medical Records – Patient Request
1-20 pages 
$35.00
Each additional page 
$0.30
Postage costs responsibility of patient 
(includes postage & registered mail)
$14.00
Please pay by cash at Front Office.