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

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• 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

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       Non-Specified Form Varies

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• 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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