Fees for Patient Pay Services

Rocky Medical Clinic Fees for Patient Pay Services

Forms

Forms Price
AISH Medical (not covered by AISH) $67.00
Attending Physician Statement $60.00
Certificate of Fitness – form only $50.00
Certificate of Fitness – exam plus form $130.00
Disability Insurance Form $60.00
Disability Tax Credit Certificate $60.00
Driver’s Medical (74.5 years and under) $75.00
Ministry of Transport Pilot’s Medical $150.00
Seniors’ Residence Medical $50.00
Pregnancy Leave/Employment Insurance $35.00
Disabled Parking Placard Application $55.00
Notes for sick leave/therapy/etc $50.00
Work Injury Employer Form $50.00
Transfer of/Request for Medical Records $25.00 and up

Clinical Services

CLINICAL SERVICES Price
Office visit for uninsured Canadian citizen or Quebec resident $38.00
Office visit for person visiting from out of country $100.00
Travel Consult $40.00
Cortisone and Gardasil Injections $15.00
All other injections (Twinrix, etc.) $10.00
Newborn Circumcision $250.00
Excision of warts, moles, etc. (not medically required), first $100.00
Excision of warts, moles, etc., each additional $60.00
Cautery of warts, moles, etc. (not medically required), first $55.00
Cautery of warts, moles, etc., each additional $15.00

Medical Supplies

MEDICAL SUPPLIES Price
Tensor Bandages $1.00/inch in width
Needle/Syringe $0.75/pair
Small Sharps Container $2.00
Large Sharps Container $6.00
Finger Splint $5.00
Paper Rolls $8.50
Sling $1.50

Make An Appointment

Please call the clinic to check for availability.