| Form Fees |
|
| 1 page |
$30.00 |
| 2 page |
$45.00 |
| Follow up forms |
$25.00 |
| |
|
| Missed Appointments |
$30.00 |
| Missed Appointment - Full Physical |
$65.00 |
| Lost RX or requisitions |
$10.00 |
| Drivers Physical |
$75.00 |
| Senior Citizen Drivers Physical |
$50.00 |
| WCB 1st Aid Physical |
$44.00 |
| Administration of Vaccines |
$15.00 |
| Travel Consultation (highly-advised that patients visit the local Travel Clinic) |
$55.00 |
| Liquid Nitrogen |
$30.00 |
| Cosmetic mole excision - cosmetic |
$75.00 |
| 2nd lesion, same sitting |
$35.00 |
| |
|
| Written certificate incl time loss benefit form (extra for examination) |
$35.00 |
| |
|
| Physical Fitness exam for school, camp, etc. |
$60.00 |
| Insurance Company Form to include Review of Records |
$120.00 |
| Extensive report for insurance |
$159.00 |
| Transfer of patient records |
$29.00 |
| Photocopying per page |
$1.30 |
| |
|
