Fees for Patient Pay Services
Rocky Medical Clinic Fees for Patient Pay Services
Forms
| Forms | Price |
|---|---|
| AISH Medical (not covered by AISH) | $80.00 |
| Attending Physician Statement | $65.00 and up |
| Certificate of Fitness – form only | $50.00 |
| Certificate of Fitness – exam plus form | $130.00 |
| Disability Insurance Form | $75.00 |
| Disability Tax Credit Certificate | $75.00 |
| Driver’s Medical (74.5 years and under) | $100.00 |
| Ministry of Transport Pilot’s Medical | $150.00 |
| Seniors’ Residence Medical | $75.00 |
| Pregnancy Leave/Employment Insurance | $40.00 |
| Disabled Parking Placard Application | $60.00 |
| Notes for sick leave/therapy/etc | $40.00 |
| Work Injury Employer Form | $50.00 |
| Transfer of/Request for Medical Records | $55.00 and up |
Clinical Services
| CLINICAL SERVICES | Price |
|---|---|
| Office visit for uninsured Canadian citizen (excl. Quebec) | $100.00 |
| Office visit for Quebec resident | $38.00 |
| Office visit for person visiting from out of country | $100.00 |
| Travel Consult | $50.00 |
| Cortisone and Gardasil Injections | $15.00 |
| All other injections (Twinrix, etc.) | $25.00 |
| 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 | $60.00 |
| Cautery of warts, moles, etc., each additional | $30.00 |
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 |