Services Highlighted in Yellow are covered by our Wellness Plans.

FORMS
Drivers Medical Exam/Pension Buy back and Form	$300
Drivers Medical Form only	$70
Aviation Medical Exams/forms	$300
Ottawa Hospital/OC Transpo Medical Certificates	$50
Camp, School, University forms	$35
Routine Sick Notes/Back to work Notes	$25
Jury Duty Letter	$40
Drug Exemption Insurance forms	$50
Paramedical Prescriptions (ie massage, physio etc without appt)	$25
Travel Cancellation Form /forms	$100
Functional Abilities forms	$50
Pre-Adoption /Foster form only	$100
Pre- Adoption/Foster exam + form (CAS)	$250
Free communicable disease certificate	$25
Vaccine review and forms (work/school)	$40
Pre-Employment (ie Fitness/hospital/nursing) certificate	$45
Modified Duty/Return to work treatment form	$40 – $100
** for third party requested forms or reports, an appropriate assessment fee may be charged, in addition to the fee charged for completiion of the form/report when assessment is not medically necessary
INSURANCE REPORTS
Insurance forms	$50-$300
Attending Physician Statements	$160-$300
OCF-3 Disability Certificate OCF-18 Treatment Plan OCF-19 Determination of Catastrohpic Impairment OCF-23 Treatment Confirmation
Life insurance Death Certificate	$50
GOVERNMENT FORMS
CPP Disability Medical Report Form (Government covers $85.00)	$150 (patient pays $65 balance)
CRA Disability Tax Credit (T2201)	$100
Federal Government Absence Certificate	$50