Direct Patient & Third Party Costs

Your guide to fees not coverd by OHIP

Please note our prices have changed as of Dec. 1, 2023

Are you aware that not all of the services that your physician provides to you are insured through the Ontario Health Insurance Plan, (OHIP)?

Payments for services not covered by OHIP will be charged directly to the patient. Some services may be requested by other third parties, such as insurance companies, lawyers etc. These will be charged to the requesting organization. Please note, no forms will be completed without a signed release from the patients.

Charging for non-OHIP services is Clinic Policy however, your primary care clinician may use their discretion in some circumstances.

Listed below are the most common uninsured medical services, including the associated costs, which are not covered by OHIP.

Visits and Procedures:

Ambulatory Blood Pressure


General Assessment


Immunization/Injection, (out of province)


Liquid Nitrogen for wart removal per treatment (1-5)


Liquid Nitrogen for wart removal per treatment (5+)


Mole, Cyst Removal, Lipomas Removal


Skin Lesion Removal


Skin Tag Removal (1-5)


Skin Tag Removal (5+)


Cortisone Injection (if purchased from the clinic)


TB Mantoux Test - one step


Reading and form

TB Mantoux Test - two step


Reading and form

Travel Immunizations - per injection


(HEP A, HEP B, Twinrix, Typhrix, Avaxim, Menactra)

Prevnar 13


Prevnar 20


Gardasil 9


Shingrix per dose




Ear Syringe


Other Services:



First 20 pages

Additional pages – $ 0.25

Chart Transfers


Missed Appointments

$30.00 to 150.00

Failure to attend appointment or cancel less that 24 hours notice

Massage/Physio Prescriptions for Insurance purposes


Immunization Record Replacement (1 free copy)


Third Party Services Forms Requiring a Physical:

Ministry of Transportation Medical Exam (form + physical)


Narrative Medical Report


Pension Buy Back (form + physical)


Admission to Retirement Home (form + physical)


Third Party Services Forms NOT Requiring a Physical:

Application for Canadian Armed Forces


Attending Physician Statement (APS) One Page


Additional Pages – $15.00

Children's Aid Society Application


Prospective Foster Parent Form

Employment Insurance, (EI) Compassionate Care Benefits


Employment Insurance, (EI) Disability/Sick Benefit/Maternity Report


Federal Disability Tax Credit Form


Life Insurance Death Certificate


Pilot License Validation


Pre-Employment/Fitness/Hospital/Nursing Home Employee


School/Camp including daycare, preschool, college or university


Fitness to work note


Sick Note


Travel Cancellation Form


Late and NO Show polices for the Pediatricians

Appointment will be cancelled and need to be rescheduled if patient/family is:

  • 10 minutes or more late for 30 minute appointment
  • 15 minutes or more late for 45-60 minute appointment
  • 20 minutes or more late for 75-90 minute appointment

No-Show Fees 

  • $50 for missed follow-up appointment (30-45 min)
  • $100 for missed new consult appointments (60-90 min)

Patient/family will not be re-booked until the NO-SHOW fee is paid