Common Uninsured Services Fees
Most Common Uninsured Services
Covered by Annual Fee if paid:
Telephone/fax prescription renewal
$25
Telephone Advice
$35-$75 I call
Missed office visit (up to 3 per year)
$40
Missed complete physical appointment (1 per year)
$77
Missed complete physical with Pap test appointment (1 per year)
$89
Missed 30 min. counselling appointment (up to 2 per year)
$63
Missed Pap test appointment
$40
Blood test /X-Ray requisitions mailed to patient
$11
Blood test/X-Ray requisitions picked up by patient
$10
Chart summaries, transfer of medical records to other MD's
$150
CPP Disability Medical Report form
$85
EI Medical Certificate
$27
Drivers medical examination form
$56
Fitness club form or letter
$36
Insurance, sickness & disability form
$30
Medical certificate
$28
Medication insurance form
$20
Referral note for insurance purposes
$20
Patient e-mail review
$10
Photocopying & faxing to a third party
$35 first 20 pages then $0.30/page
Pre-travel consultation
$50
Referral to doctor when not associated with OHIP service
$40
Replacement of immunization record lost by patient
$10
Revenue Canada disability tax credit form
$48
School/ Camp form
$27
TB test and letter/form-1 step
$45
TB test and letter/form-2 step
$65
Travel cancellation insurance form
$37
Uninsured immunization visit (not including cost of vaccine)
$25
Photocopying of patient results
$1 I page
Not covered by Annual Fee:
Third party medical exam (insurance, pre-employment, driver’s, etc.)
$228
Telephone consultation with non-health professional
$361/hour
Medico legal and other narrative reports
$361/hour
Covered by Annual Fee if paid:
Telephone/fax prescription renewal
$25
Telephone Advice
$35-$75 I call
Missed office visit (up to 3 per year)
$40
Missed complete physical appointment (1 per year)
$77
Missed complete physical with Pap test appointment (1 per year)
$89
Missed 30 min. counselling appointment (up to 2 per year)
$63
Missed Pap test appointment
$40
Blood test /X-Ray requisitions mailed to patient
$11
Blood test/X-Ray requisitions picked up by patient
$10
Chart summaries, transfer of medical records to other MD's
$150
CPP Disability Medical Report form
$85
EI Medical Certificate
$27
Drivers medical examination form
$56
Fitness club form or letter
$36
Insurance, sickness & disability form
$30
Medical certificate
$28
Medication insurance form
$20
Referral note for insurance purposes
$20
Patient e-mail review
$10
Photocopying & faxing to a third party
$35 first 20 pages then $0.30/page
Pre-travel consultation
$50
Referral to doctor when not associated with OHIP service
$40
Replacement of immunization record lost by patient
$10
Revenue Canada disability tax credit form
$48
School/ Camp form
$27
TB test and letter/form-1 step
$45
TB test and letter/form-2 step
$65
Travel cancellation insurance form
$37
Uninsured immunization visit (not including cost of vaccine)
$25
Photocopying of patient results
$1 I page
Not covered by Annual Fee:
Third party medical exam (insurance, pre-employment, driver’s, etc.)
$228
Telephone consultation with non-health professional
$361/hour
Medico legal and other narrative reports
$361/hour