Patient Information
What are "non-OHIP" covered services or "uninsured services"?
Non-OHIP covered services are those services provided to patients that are not covered by the Ontario Health Insurance Plan (OHIP). The Ministry covers all insured medically necessary services provided by physicians, however, it does not pay for services that are not medically necessary. These may include: writing sick notes, cosmetic procedures, charges for missed appointments, completing forms for daycare, insurance, legal or employment purposes, or if your health card is not valid on the day of your appointment.
Why am I being charged for these services?
OHIP pays physicians for most medical services delivered to patients. Services not covered by OHIP or another insurance plan are called uninsured services. Your physician will request a payment from you for those services. It is the patient's responsibility to pay for uninsured services.
How are the uninsured fee rates determined?
When fees are charged for uninsured services, they are based on the Ontario Medical Association's suggested fees as found in the most current edition of the OMA Physician's Guide to Third Party and Other Uninsured Services.
What if I have questions?
For more details please see the Ministry's website or contact your nearest Ministry office.
You can always contact the office for more information.
Non-OHIP Insured Services
Square One Health Group
Uninsured Services
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Completion of Forms for Physicals:
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School / Camps
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$25.00
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Driver’s Physical
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$150.00
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Disability Certificate Form OCF-3
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$130.00
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Completion of Work-Related Forms/Notes:
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Sick Notes / Back to Work Notes / Day Care Note (free of communicable disease)
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$20.00
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Attending Physician Statement
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$200.00
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Federal Employee; Blue Form
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$25.00
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Admission to Day Care / Pre-School
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$25.00
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Admission to Community College/University/Institute
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$25.00
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Disability Tax Credit
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$85.00
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Immigration Letter/Invitation
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$75.00
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CRA Letter
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$50.00
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Insurance Related Sick Note/Form
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$50.00
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Travel Related
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Travel Cancellation Insurance Form/Certificate
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$30.00
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Travel Consult
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$60.00
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Travel Immunization (per injection)
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$20.00
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Services Not Cover by OHIP
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Ear Syringing
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$25.00
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Wart Removal
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$20.00
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Skin Tag Removal
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$25.00 and up
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Regular Office Visit (Non-OHIP)
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$65.00
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Missed Physical Appointment
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$65.00
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Missed Follow Up/ Regular Appointment
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$40.00
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TB Skin Test (For Educational purpose is Covered by OHIP-Proof Requested.):
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1-Step Test
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$20.00
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2-Step Reading
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$20.00
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Photocopying of chart/Medical chart transfer**
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$30.00 +
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**For the first 20 pages then $0.25 per page thereafter please round to the nearest dollar
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Please be advised that the above fees are based on the guidelines set forth in the Ontario Medical Association's Physician's Guide to Uninsured Services and are subject to regular revision. The fees are also subject to change at the discretion of individual providers at the Square One Health Group.
We understand the importance of transparency and will make reasonable efforts to communicate any fee changes through our official communication channels, such as our website, email notifications, or direct correspondence. It is recommended that you regularly review our fee schedule and related policies to ensure you have the most up-to-date information regarding our charges.
Transfer of Medical Records Authorization Form Pdf.
Privacy Policy Information Pdf.