Uninsured Services & Non-OHIP Fees

At Empyrea Medical Centre, our goal is to provide you with exceptional, comprehensive healthcare. While the Ontario Health Insurance Plan (OHIP) covers most of your medical visits and essential treatments, there are several services that OHIP does not fund.
 
These are classified as uninsured services. They require significant administrative time or materials from our medical and administrative team.
 
Following the annual guidelines set by the Ontario Medical Association (OMA), our clinic charges standard fees for these requests. Payment for these services is the responsibility of the patient.
 
Forms are completed by your Doctor during their own time. Please allow for up to 2 weeks for completion of these documents.
 
Book Appointment Register as Patient

Standard Fee Schedule

The following fees apply to services that are not covered by OHIP. Fees may vary depending on the complexity of the request or service.

Forms, Notes & Letters

Fees for forms, medical notes, letters, and other uninsured documentation.

✦ Sick Notes / Return-to-Work Forms $25
✦ Insurance Notes for Massage, Physiotherapy, Orthotics, etc. $25
✦ School, Camp, or Daycare Forms $50
✦ Pre-Employment Physical & Form $100
✦ Attending Physician's Statement Forms Depending on length and complexity $200+
✦ Insurance Forms Depending on length and complexity $150+
✦ Special Drug Authorization Form (non-ODB, Private Insurance) $50
✦ Driver’s Medical Examination and Form (MTO) $200
✦ Disability Tax Credit Application $200
✦ Other Forms (non-insured) Physician's hourly rate

Administrative & Pharmacy Requests

Fees related to administrative requests, documentation, and services provided outside of a scheduled visit.

✦ Printing / Photocopying / Emailing Chart Notes At patient's request — first 10 pages $10
✦ Prescription Renewals Without an Appointment $20
✦ Transfer of Medical Records Includes time for chart review $100
✦ Missed Appointment — Regular Visit Applies if cancelled with less than 24 hours' notice $50
✦ Missed Appointment — Physical / Long Visit Applies if cancelled with less than 24 hours' notice $100

Uninsured Patients & Procedures

Fees for patients without OHIP coverage and procedures that are not insured by OHIP.

✦ Consultation / Office Visit Without OHIP Coverage $150
✦ Travel Advice or Consultation $100
✦ TB Skin Test — Employment or Volunteer Purposes $50 per step
✦ Liquid Nitrogen for Cosmetic Spots Depending on the number of lesions $50+
✦ Ear Wax Flushing — At Patient's Request $50
✦ Sclerotherapy for Varicose Veins $50
✦ Sclerotherapy for Spider Veins $100+
Please note: Fees are subject to change. Payment may be required before forms, documents, or uninsured services are completed.