UNINSURED SERVICES
These are suggested rates by Ontario Medical Association. 
Most common

  • Sick or back to work notes $20

  • Missed regular appointment (with less than 24 hour notice) $60

  • Missed periodic health exam/physical (with less than 24 hour notice) $100

  • Disability tax credit form $45

  • Certificate of freedom from communicable disease $20

  • Allied Health Professional notes (ie physiotherapy, massage therapy, orthotics) at patient request $20

  • Prescription renewals (without appointment) $20

  • Replacement of lost requisition $15

  • Replacement of lost immunization records or amalgamation of immunization records $20 

  • TB skin test (for employment purposes, includes 2 visits for injection and reading) $40

  • Privately paid injection or immunization (ie: travel vaccines) $20/vaccine

  • Third party physical (including form) $175

  • Uninsured visit (includes non presentation of health card or invalid health card) $75

  • Uninsured periodic health exam $110

  • Transfer of medical records (paper) $30 - first 30 pages, $0.25/page thereafter + disbursements

  • Transfer of medical records (CD) - physician hourly rate + disbursements

  • Copy of chart content for patient $2 (first 2 pages), then $0.25 (each additional page)

  • Cosmetic procedures are variable, please inquire for details

  • Cryotherapy (ie: warts or other skin lesions) $20 first lesion and $10 each additional lesion

  • Travel cancellation certificate $40

  • School physical form (includes physical and form completion) Variable

  • Patient interview for practice admission (Note: patient interview refers to a 15 minute patient conducted interview of a physician) $100

  • Pre-adoption examination and evaluation for Children's Aid Society $210

  • Children's Aid Society (CAS) Application for Prospective Foster Parent $60

  • Letter to excuse from jury duty or physical fitness program/facility $30

  • Medical Certificate Employment Insurance Sickness Benefits INS5140 $30

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Quebec Patients 

  • Patient from Quebec with a valid RAMQ card are expected to pay their fees in full at their appointments and submit claim form to the government for reimbursement.

  • The fees stated below are based on recommendations for uninsured services by the OMA

  • Any regular visit is $70

  • A physical exam is $110

  • Add-on fee for a pap test is $20

  • The visit might be subject to additional fees for certain procedures, such as (but not limited to) immunizations, biopsies, cryotherapy, ear syringing.

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Employment and Educational-related Forms

  • Schools/Camps $25

  • Admission to daycare, preschool, university (including out of province and international universities) or any other educational institution $25

  • Pre-employment certification of fitness/fitness clubs (no examination) $40

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Insurance Forms

  • Attending Physician's Statement $150

  • Short-term/Long-term disability forms are billed at the physician's hourly rate

  • System-Specific or Disease Specific Questionnaire $100

  • Insurance Medical Examination $230

  • System-Specific Examination $110

  • Clarification Report $375/hour

  • Full Narrative Report $375/hour

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© 2017 by Walkley Medical Centre.