St. Laurent Medical Centre and your family doctors are committed to provide you with the best medical care, in a pleasant and professional environment. However, there are services that you may request from your doctor that are not considered medically necessary by Ontario Health Insurance Plan (OHIP) and are therefore not paid by OHIP. These services, such as: insurance forms, legal letters, sick notes, cosmetic medical procedures, etc., are called ‘non-insured or uninsured services.’ your doctor at the St. Laurent Medical Centre will charge for uninsured services in accordance with the fees guidelines set by the Ontario Medical Association (OMA) and the College of Physicians and Surgeons of Ontario (CPSO).
The following list accounts for most commonly requested uninsured services. However, if the service you request is not on the list below, please communicate it to the clinic’s staff or your doctor and will be given further clarification.
All uninsured services must be paid in full when rendered. A receipt will be provided upon settlement of the account.
| Service | Cost |
|---|---|
| PRESCRIPTION RENEWALS WITHOUT REVIEW | $25 per request |
| EAR WASH | $40 |
| ILLNESS AND RETURN TO WORK NOTES | $30 |
| MASSAGE THERAPY AND ORTHOTICS | $35 |
| DAY CARE NOTES | $30 |
| SCHOOL / CAMP FORMS | $30 |
| TRAVEL CANCELLATION FORMS | $50-75 |
| REFERRAL NOTE FOR CHIROPRACTOR, PHYSIOTHERAPY, ETC. | $35 |
| TRANSFER OF MEDICAL RECORDS (First 20 pages) | $35 |
| TRANSFER OF MEDICAL RECORDS ($0.25/page thereafter) | Variable |
| LETTERS ON BEHALF OF PATIENTS | $25-200 |
| MEDICAL SUPPLIES, DRESSINGS, ETC. | $25 |
| LOST PRESCRIPTIONS, NOTES, REFERRALS | $25 |
| TB TEST & READING & FORM (form alone) | $65 (form alone $20) |
| MEDICAL EXAMINATION FOR RETURN TO WORK REQUESTED BY EMPLOYER | $75 |
| DRIVER'S MEDICAL FORM (MOT) | $160 |
| THIRD PARTY PHYSICAL EXAM | $160 |
| PHOTOCOPYING/PRINTING | $1 per page |
| TRAVEL INFO/VACCINATION | $40 |
| OCF-3 DISABILITY CERTIFICATE | $160 |
| COMMERCIAL WEIGHT LOSS PROGRAM | $30 |
| EMPLOYMENT INSURANCE / MATERNITY CERTIFICATE | $30 |
| FITNESS CLUB FORMS | $42 |
| PRIVATE INSURANCE FORMS | $30-500 |
| PRE-EMPLOYMENT CERTIFICATE OF FITNESS | $42 |
| JURY DUTY LETTER | $35 |
| CERTIFICATE OF MEDICAL STATUS | $25 |
| REVENUE CANADA DISABILITY FORM | $83 |
| DISABILITY TAX CREDIT CERTIFICATE | $83 |
| CHILDREN'S AID SOCIETY FORMS | $50 |
| REPLACEMENT OF IMMUNIZATION CERTIFICATE | $40 |
| FORMS REQUIRED FOR VOLUNTEER WORK | $30 |
| MISSED APPOINTMENT | $40 |
| MISSED ANNUAL PHYSICAL EXAMINATION | $100 |
| LEGAL REPORTS | OMA RATE |
| SLMC PARKING FEE | $3 |
