Common Uninsured Services Fees
Most Common Uninsured Services
Covered by Annual Fee if paid:
Telephone/fax prescription renewal
$28
Secure Messaging directly with Physician
$20 / encounter
Sick Note for Absence from Work or School
$28
Insurance Note/ Massage Therapy
$28
Missed office visit (up to 3 per year)
$50 each missed visit
Missed complete physical appointment (1 per year)
$90
Missed complete physical with Pap test appointment (1 per year)
$110
Missed 30 min. counselling appointment (up to 2 per year)
$90
Missed Pap test appointment
$70
Chart summaries
$45/15 minutes, after the first 15 minutes
Electronic transfer of medical records
$30
EI Medical Certificate
$45.25
Ear Wash
$40
Fitness club form or letter
$47.75
Insurance, sickness & disability form
$36.25
Medical certificate
$46.75
Medication insurance form
$28.00
Referral note for insurance purposes
$28.00
Patient e-mail review
$10
Photocopying & faxing to a third party
$30 first 20 pages then $0.25/page
Pre-travel consultation
$55
Referral to doctor when not associated with OHIP service
$40
Replacement of immunization record lost by patient
$10
School/ Camp form
$36.25
TB test and letter/form
$75
Travel cancellation insurance form
$150
Uninsured immunization visit (not including cost of vaccine)
$50
Photocopying of patient results
$1 I page
Not covered by Annual Fee:
Third party medical exam (insurance, pre-employment, driver’s, etc.)
$260
CPP Disability Medical Report Form
$220
Revenue Canada Disability Tax Credit Form
$256
Telephone consultation with non-health professional
$455/hour
Medico legal and other narrative reports
$455/hour
Covered by Annual Fee if paid:
Telephone/fax prescription renewal
$28
Secure Messaging directly with Physician
$20 / encounter
Sick Note for Absence from Work or School
$28
Insurance Note/ Massage Therapy
$28
Missed office visit (up to 3 per year)
$50 each missed visit
Missed complete physical appointment (1 per year)
$90
Missed complete physical with Pap test appointment (1 per year)
$110
Missed 30 min. counselling appointment (up to 2 per year)
$90
Missed Pap test appointment
$70
Chart summaries
$45/15 minutes, after the first 15 minutes
Electronic transfer of medical records
$30
EI Medical Certificate
$45.25
Ear Wash
$40
Fitness club form or letter
$47.75
Insurance, sickness & disability form
$36.25
Medical certificate
$46.75
Medication insurance form
$28.00
Referral note for insurance purposes
$28.00
Patient e-mail review
$10
Photocopying & faxing to a third party
$30 first 20 pages then $0.25/page
Pre-travel consultation
$55
Referral to doctor when not associated with OHIP service
$40
Replacement of immunization record lost by patient
$10
School/ Camp form
$36.25
TB test and letter/form
$75
Travel cancellation insurance form
$150
Uninsured immunization visit (not including cost of vaccine)
$50
Photocopying of patient results
$1 I page
Not covered by Annual Fee:
Third party medical exam (insurance, pre-employment, driver’s, etc.)
$260
CPP Disability Medical Report Form
$220
Revenue Canada Disability Tax Credit Form
$256
Telephone consultation with non-health professional
$455/hour
Medico legal and other narrative reports
$455/hour