- Missed Regular Appointment $75
- Missed Drivers Medical or Yearly Screening (Check up) $160
- Missed Procedure Appointment (IUD insertion/Removal, Excision/Biopsy, Injection, Pap) $200
- Uninsured Visits (No eligible Health Care) Regular Visit (up to 10 min) $40, Complete Exam $160
- Record Request: $25 (first 20 pages, 0.25/page thereafter)
1. Blue Cross Special Authorization forms: $55
2. General insurance eligibility examination and form completion: $480
3. Attending physician’s statement: $375
4. Disability benefit report: $245
5. Medical examination report: $960 – $2,340
6. Third-party requested letters on patient attended: $480
7. Proof of death physician’s statement other than vital statistics: $85–150
8. Note of fitness or illness: $145
9. Periodic industrial health or Ministry of Transport Licenses: $480
10. Employment Insurance forms: $150
11. Driver’s medical: $295
12. Veteran’s Affairs: $135
13. Canada Revenue Agency disability tax credit: $120
14. Canada Pension Plan (CPP) disability: initial medical report: $100
15. Canada Pension Plan (CPP) disability: Reassessment Medical Report: $50
16. Canada Pension Plan (CPP) disability: Medical Report – Recurrence of the Same Medical Problem: $50
17. Canada Pension Plan (CPP) disability: Medical Report – Scan-able Impairment Evaluation: $50
18. Canada Pension Plan (CPP) disability: Narrative Report Photocopied information from patient’s chart and/or brief statement (less than 15 minutes): $50
19. Canada Pension Plan (CPP) disability: Narrative Report Short narrative report – one page (15–20 minutes): $150
20. Canada Pension Plan (CPP) disability: Narrative Report Full narrative report – two pages (40–45 minutes): $450
21. Canada Pension Plan (CPP) disability: Narrative Report Detailed narrative report – three or more pages (1 hour): $650
22. Transfer of, and access to, medical records under the Health Information Act (HIA).
1) The regulations state that the request will not be processed until:
a) The applicant has agreed to pay the fee.
b) The applicant has made a deposit of at least 50% of the fee.
Basic fee of $25, plus:
- Fee for severing, plus
- Material costs (excluding basic mailing costs included in the basic fee)
Time to review to determine whether severing is required, or to review and identify the parts of the record to be severed:
- Physician time: $45 per 1/4 hour to a maximum of 3 hours
- Technician (staff) time: $6.75 per 1/4 hour to a maximum of 3 hours
- Time to supervise applicant’s examination of original records: Technician (staff) time $6.75 per 1/4 hour
Photocopies,hardcopy, laser print, and computer, print outs
- $0.25 per page after the first 20 pages
Producing a record from an electronic record
- Computer processing:
- Physician time: $45 per 1/4 hour
- Technician (staff) time: $6.75 per 1/4 hour
- Time to supervise applicant’s examination of original records: Technician (staff) time $6.75 per 1/4 hour
- Computer report generation:
- $10 per 1/4 hour
Charges to retrieve records or to return records, or both, from another location
- Technician (staff) time: $6.75 per 1/4 hour
Courier charges or delivery charges, or both, to send copies to applicant other than by mail or fax
- Technician (staff) time: $6.75 per 1/4 hour Plus actual courier/delivery costs
Any expedited requests: Subject to additional costs at a minimum of 200% of the total expected cost
As a Patient Medical Home, our clinic shares its space with Rxcellence Pharmacy, Connect Hearing and other services in the building. Please be respectful of other people’s space.
As courtesy to other patients, if you are late, your appointment will be shortened to the remainder of the original scheduled appointment. If you are more than 10 minutes late, you may be asked to wait as a walk-in or be asked to reschedule.
