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    • Home
    • Book an Appointment
    • Private Pay Services
    • Contact Us
    • Privacy
    • Patient Responsibilities
  • Home
  • Book an Appointment
  • Private Pay Services
  • Contact Us
  • Privacy
  • Patient Responsibilities

Frederick Street Family Medicine

Frederick Street Family MedicineFrederick Street Family MedicineFrederick Street Family Medicine

formerly Tannery Medical Centre

formerly Tannery Medical Centreformerly Tannery Medical Centre

Private Pay Services

What are private pay services?

Private pay services are those that incur fees because they are not covered by OHIP. These fees must be paid prior to redeeming services. While most of the healthcare services we provide are coverered by OHIP, the following is a list of services and fees that are not covered. These charges established by the Ontario Medical Association and are reviewed on an annual basis.

NOTES

  • Sick note: $25
  • Return to work note: $25
  • Note for massage/physio/chiro: $25




GOVERNMENT FORMS 

  • CPP Disability Medical Report: $85 
  • CPP Narrative Medical Report: $150
  • Revenue Canada/Fed Disability tax credit: $80 
  • Children's Aid Society Application for Prospective Foster Parents: $60 
  • Medical certificate employment insurance sickness benefits: $40

INSURANCE CERTIFICATES

  • Treatment Plan (OCF-18): $255
  • Disability Form (OCF-3): $240
  • Determination of Catastrophic Impairement (OCF-19): $200 
  • Treatment Confirmation (OCF-23): $240
  • Travel Cancellation: $50 
  • Disease/System specific questionaire: $100
  • System Specific Examination: $125
  • Insurance Medical Exam (aseessment + report): $250
  • APS Attending Ph

INSURANCE CERTIFICATES

  • Treatment Plan (OCF-18): $255
  • Disability Form (OCF-3): $240
  • Determination of Catastrophic Impairement (OCF-19): $200 
  • Treatment Confirmation (OCF-23): $240
  • Travel Cancellation: $50 
  • Disease/System specific questionaire: $100
  • System Specific Examination: $125
  • Insurance Medical Exam (aseessment + report): $250
  • APS Attending Physician Statement: $200
  • Medical certificate for employment insurance compassionate care benefits: $60

CHART COPY

  • $30 for first 20 pages (0.25 cents each page after)
  • confidential shipping with tracking of records $15.00 
  • $50 for digital conversion




CLINICAL SERVICES

  • General Assessment or Physical: $245
  • Intermediate Assessment: $105
  • Minor Assessment: $65
  • TB Test for Employment (1 step): $60
  • TB Test for School: No fee
  • Uninsured Immunizatioms: $20

FORMS

  • School/camp: $35
  • Admission to daycare/preschool, university: $35
  • Pre-employment certificate of fitness/fitnss clubs: $45
  • Hospital/nursing home employee pre-employment certificate: $45
  • Drivers medical exam with physical: $260
  • 3rd party medical exam: $200
  • Pre-adoption Examination + Evaluation: $210
  • Short Term Disability Form: $75
  • Long Term Dis

FORMS

  • School/camp: $35
  • Admission to daycare/preschool, university: $35
  • Pre-employment certificate of fitness/fitnss clubs: $45
  • Hospital/nursing home employee pre-employment certificate: $45
  • Drivers medical exam with physical: $260
  • 3rd party medical exam: $200
  • Pre-adoption Examination + Evaluation: $210
  • Short Term Disability Form: $75
  • Long Term Disability Form (APS): $200
  • Workplace injury forms (non WSIB): $50-$75
  • MTO report: $75
  • MTO mental health or substance abuse report: $100


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