(fees subject to change without notice)
Missed Appointment (without 24 hours notice) |
$30.00 |
Missed Physical (without 24 hours notice) |
$60.00 |
Expired OHIP Card - General Visit |
$33.00 |
Physical (Drivers)/By 3rd party request |
$75.00/$125.00 |
Pre-employment Certificate of Fitness |
$20.00-$35.00 |
Applications/Forms (Insurance, Disability, etc) |
$75.00 |
WSIB Form 8 HPR/FAF - Paper/E-Version |
$65.00/$75.00 |
Applications/Forms plus physical examination |
$125.00 |
TB test (for employment) 1 Step/2 Steps |
$40.00/$60.00 |
Life Insurance death certificate |
$45.00 |
CPP Disability medical report form |
$85.00 |
Insurance: #OCF-3 disability certificate |
$135.00 |
Doctor Note (Back to work/Sick/Day Care) |
$10.00-$20.00
|
Forms for insurance coverage of massage therapy, compression stocking, orthotics etc. |
$20.00 |
Maternity Leave, employment, sickness benefit Forms |
$30.00 |
Pregnancy Test |
$10.00 |
IUD Insertion |
$45.00 |
Charts: $1/page first 30 pages then $0.25/page thereafter |
Up to $30.00 + $0.25 per page |
Photocopying |
$1.00 per page |
Skin procedure - mole, lesion, skin tag removal |
$20.00 each |
Pre-travelling counseling + Rx |
$40.00 |
Travel related vaccine (hepA, hepB, Twinrix, Typhoid, Menactra, etc) |
$10.00 |
Form for compassionate care benefits, trip cancellation |
$40.00 |
CRA Disability Tax Credit |
$25.00 |
Payments for the above services are to be made payable to:
Petawawa Centennial Family Health Centre