Uninsured Services Fee Schedule

The following uninsured fees are fully covered by the membership fee for our Ongoing Care Program. The amounts shown below indicate the value of each uninsured service if charged separately.

Service Description Pay per service fee
Missed or Cancelled Appointments Missed appointment $100.00
Late Cancel within 24 hours notice $100.00
Office Visit Canadian resident with no valid health card $100.00
Out of country resident $225.00
Health Professional medical advice access Email Advice (nurse during business hours) $60.00
Telephone advice (nurse during business hours) $60.00
Mayo Clinic Second Opinion and Medical Fees Mayo Clinic Second Opinion $1500+
Medical concierge service to expedite appointments through private channels and internationally ExecHealth Coordination fee $2000.00
Prescriptions Prescription refills by phone or fax (Emergency short term refills at physician’s discretion only) $50.00
Lost prescriptions $25.00
Transfer of Individual Records First record (1-20 pages) $30.00
Additional records/page $0.25
Lab results photocopy $2.00
Tests TB skin test (third party request) $30.00
1 step $80.00
2 step $160.00
Supplies Non-insured medical supplies $10.00+
Note School/College/University sick note $26.20
Illness/return to work notes (simple) (not including forms provided by employer) $18.00
Lost Notes $25.00
Forms Nursing homes/hospital volunteer forms $35.00
Commercial weight loss programs $30.00
Private respite care form (with examination) $65.00
Fitness club forms $35.00
Attending physician’s statements (may include examination) $134.00+
Immunization card replacement $25.00
Driver’s Medical Form $53.70
Day Care Application Form (with examination) $26.20
Pre-Operative Forms $117.85+
School/Camp form $26.20
Federal & Insurance Forms Federal Tax Credit and related forms $44.75
CPP Disability form (charge in excess of government paid fees) $85.00
Private insurance sickness/disability form $134.05
Life insurance death certificate $44.75
Employment Insurance/Maternity Certificate $26.90
Travel cancellation insurance form (with examination) $35.85
Insurance coverage of physiotherapy, massage therapy, accupuncture, compression stockings & orthotics $23.55
Other Items Letters at patient’s request $400.00+

Uninsured fees follow the recommendations of the College of Physicians and Surgeons ofOntario and the Ontario Medical Association. Clients can refer to the College of Physician and Surgeons of Ontario Patient Information sheet on Block Fees and Uninsured Services at: https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Uninsured-Services-Billing-and-Block-Fees