Table of Non-Insured Services
Please note: Fees may vary based on the time required and the complexity of the task.
| Service | Fee |
|---|---|
| Procedures | |
| Physician Ear syringing (Nurse syringing is free) | $50 |
| Injections (e.g., Gardasil, Twinrix, Havrix, Shingrix) | $20 |
| Excision and suturing of benign lesion | $70 - $100* |
| Liquid Nitrogen treatment (e.g., seborrheic keratosis, non-plantar warts, skin tags) | $50 |
| Skin tag removal 1 – 10 | $60 |
| Skin tag removal 10 – 20 | $80 |
| Prescriptions and Referrals | |
| Prescriptions without office visit (more than 4 requests per year) | $15 |
| Referral for massage, physiotherapy, orthotics, medical supplies, etc. (outside office visit) | $15 |
| Uninsured Appointments | |
| Missed appointments | $30 |
| Certificate of Health visit (including brief form) | $40 |
| Travel advice visit | $50 per 15 min |
| Physical Exams | |
| Drivers’ Physical (including form) | $80 |
| Extensive physical and form | $150 |
| Physical requested by patient (i.e., no medical reason) | $75 |
| Form Completion | |
| Sick note | $10 |
| Insurance form | $20 - $40* per page |
| Work Leave form | $20 - $40* per page |
| Disability Tax Credit Certificate | $100* |
| Canada Pension Form (note $85 of this is paid by Government – remaining fee billed to patient) | $100 - $150* |
| Disabled Parking form | $15 |
| Exception Drug Status Form (e.g., Blue Cross) | $15 |
| Nursing Home / Institutional Admission Form | $40 |
| Immunization record | $20 - $40* |
| Other Services and Administrative Work | |
| Photocopying or printing | $0.25 per page |
| Medical record transfer or copy of chart (plus mailing charges as applicable) | $0.25 per page |
| Telephone advice from Physician if not covered by MSI | $15 |
| Long distance calls and fax charges | $ at cost |
Fee modification is subject to the discretion of treating physician.