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Patients guide to uninsured services 

Some of the services you request from physician are not covered by OHIP. The fees listed below are based on the Ontario Medical Association's suggested fees as per January 2022

  • Sick note/Back to work /daycare note (free of communicable disease) $22

  • Modified duty note/Return to work treatment form $30-$80

  • Ottawa Hospital/OC Transpo work form and FAF $50

  • Notes for insurance coverage of: Physiotherapy, Psychotherapy, Massage, Acupuncture, Chiropracator, Compression stockings, Orthotic, Braces, any medical appliances (Glucometer, Blood presuure machine) ....etc $20

  • Preemployment Certificate of Fitness form $42

  • Fitness Club Form $42

  • Forms required for volunteers at nursing homes/Hospital $42

  • Forms for physicals for schools, cams, preschool, day care, university/educational institutes $31.5

  • Jury Duty Letter $30

  • Travel Cancellation Certificate $45

  • Driver's Medical Exam and Form $180

  • Children's Aid Society Application for prospective foster parent $60

  • A prescription renewal without a visit with your primary care provider $20

  • A referral to an Allied Health Professional requested for documentation purposes $20

       Non-Specified Form Varies

  • Insurance certificate OCF-3 Disability Certificate $160

  • Insurance certificate OCF-18 Treatment Plan $160

  • Insurance certificate OCF-19 Determination of Catastrophic Impairment $132

  • Insurance certificate OCF -23 Confirmation of treatment $159

  • Insurance medical examination (Assessment and report) $260

  • Clarification Report $429.00/hour

  • Full Narrative Report $429.00/hour

  • CRA Disability Tax Credit Certificate (Form T2201) [Filling of the form does not ensure qualification for the program] $83

  • CPP Disability Medical Report benefit Form (SCISP-2519) (Partially reimbursable by Service Ontario) $120

  • CPP Narrative medical report (reimbursable by Service Ontario up to $150 based on complexity)  $150.00

  • Attending physician statement $160

  • Routine appointment without valid OHIP Card or for Quebec insured patients $70

  • Periodic Health Exam/Full Physical without valid OHIP Card or for Quebec insured patients $150

  • Pap Test (when done earlier than OHIP. Covered/Recommended frequency) $110 [+ Lab Fee] Preoperative history and physical requested by surgeons and dentists $150

  • Injections needed for travel [Hep. A, Hep. B, Twinrix Gardasil, Menactra, Shingrix ..] $20/Injection

  • Travel Advice $60

  • Cryotherapy [Warts or other skin lesion that are not covered by OHIP] $20/Lesion

  • Chart Review Physician Hourly Rate $429.00/hour

  • Chart Review Physician Hourly Rate Ear Syringe/Wax Removal $30

  • Urine Pregnancy Test $5

  • TB Skin Test [for employment purposes]: One Step [Includes 2 visits for injections and reading] $50

  • TB Test Two Steps $75

  • Missed appointment without 24h notice $40

  • Missed periodic health exam without 24h notice $80

  • Photocopying/Printing of report/Lab results/Xray Results $1/Page

  • Transfer medical records to another physician and electronic transfer $30 [First 20 pages, then $0.25 Per additional Page]

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