This is a list of example prices for services that are not covered by health insurance at our clinic. Our prices follow the Ontario Medical Association’s suggested fees and are checked against local clinic rates to make sure they are fair. If you want, you can compare our prices with other nearby clinics that share their pricing online.

Prices may change from time to time. For the most accurate and up-to-date prices, please check in at the clinic. If you want to be sure before your visit, call us to confirm the current price.

Services & Suggested Rates

• Consult for patients without valid health insurance
 – $100
 – $60 for a follow-up of the same issue within 2 weeks

• TB skin test (for purposes other than school, Ministry of Health requests, Long-Term Care admission and physician-deemed medically necessary purposes)
 – $110 uninsured (includes visit) for administration
 – $50 uninsured for reading
 – $30 per visit for insured

Ontario Medical Association Suggested Form and Administrative Fees

Charges for Reproduction/Transmission of Medical Records
• Copying/print: $30 (first 20 pages) + $0.25 per page thereafter
• Electronic transfer: $30
• Physician review of records (where applicable): $45 per 15 minutes after first 15 minutes

General Notes & Forms
• Back to work note, sick note, or daycare note (free of communicable disease): $25
• MTO – Medical Report (Driver’s Physical): $180

Federal Forms
• Disability Tax Credit Certificate – T2201: $110
• Medical Certificate for Employment Insurance Compassionate Care Benefits – INS-5216: $75
• Medical Certificate for Employment Insurance Sickness Benefits – INS-5140: $50

Insurance and Disability
• Attending Physician Statement (Life/Disability Insurance Application): $180
• Insurance Certificates:
 – OCF-3 Disability Certificate: $256
 – OCF-18 Treatment Plan: $272
 – OCF-19 Application for Determination of Catastrophic Impairment: $151
 – OCF-23 Treatment Confirmation: $256
• Short-Term Disability / Fitness to Work / Functional Abilities Forms (Non-WSIB): $50

School and Workplace
• Proof of Immunization Forms: $75

Miscellaneous
• CAS – Medical Report (Adoption / Foster / Kinship / Customary Care Applicants in Ontario): $120
• Uninsured Prescriptions (Refills, Orthotics, Massage, etc.): $25 each if sole purpose of visit