Uninsured Services and Blocked Fees

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Arbour Family Medical Fees For Uninsured Services Not Covered By OHIP

Effective January 1, 2023

(The following charges are based on review of the medical condition and are payable whether or not a form is filled)

An additional charge applies if examination is required

Notes     Sick/Back to Work/School/Daycare:  $23.00

Surgical Removals:  $88.00

Removal of Cosmetic Lesions (liquid nitrogen):  $26.00

Travel Advice:$60.00 / person

          Immunization for Travel Outside of Canada:  $25.00 / injection

Missed Scheduled Appointment (Within 24 hour cancellation) 

         Regular Appointment:  $40 Evening/Weekend

         Physical/Produce Appointment:  $80

Patients Without OHIP (Uninsured Examination)

       Minor Assessment:  $63 OMA rate

       Intermediate Assessment:  $98 OMA rate

       Adult General Assessment (Physical):  $175 OMA rate

       Child Assessment (Annual Health exam after 2nd Birthday):  $116 OMA rate

       Immunization / Allergy Shots: $25

        Any related diagnostic testing will be directly billed to the patient

        Failure to provide valid health card within 3 months will result in direct bill at OMA rates

Photocopy Charges

       Patient Requested:  $1 / page

Transfer of Medical Records (including minimum 10 year storage)

       Individual:  $35 minimum (first 20 pages + $0.3 per page over 20)

       Family:  $70 minimum (first 20 pages + $0.3 per page)

              Note - If physician is required to review the chart, there will be an hourly rate assessed

Long Distance Phone Calls or Faxes:  $21 minimum charge

Prescription Repeats by phone/fax to pharmacies:  $23

Physio, Massage, Orthotics Prescriptions etc. given to patient or faxed:  $23

Third party Physical Exams (including forms)

       Camp/School Form (form and assessment):  $115 assess + $32.50 form

       Driver's Medical Report Including Medical Exam:  $289.00

       Adoption Application form and Physical:  $243.00

Completion of Forms

       Trip Cancellation Form:  $44-$66

       Maternity Leave Form:  $44

       Private Insurance Disability / Sickness Form:  $44-$66

       Federal Tax Credit & Related Forms:  $150

       Certificate of Health Verification:  $44

       Fitness and Weight Loss Form (does not include physical):  $44

       Private Respite Care Form:  $82

Demand Surcharge (same day):  additional $30 / form

Travel (Greater than 8kms or 15mins): Independent Consideration

NSF Cheques:  $40

Note: A Higher rate Is Applicable For Services Provided After Hours

Fees Subject To Change Without Notice

Proud Partners of the Guelph Family Health Team.

Arbour Family Medical Centre offers comprehensive health care services for the whole family.

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