LIST OF FEES
| OMA 2026 Uninsured Services | |
| Charges for reproduction/transmission of medical records | $30 (first 20 pages + 0.25 thereafter) |
| Physician review of records | $30 for 1st 15 min and $45/15 min thereafter |
| Camp and School Physical Forms | $40 |
| Pre-employment Certificate of Fitness | $50 |
| School or Work Forms to Verify Immunization Status | $50 |
| TB Skin Testing, when not for medical necessity | $50/$70 |
| Back to work note, sick note or daycare note | $30 |
| Functional Ability Forms | $50 |
| Disability Tax Credit Application | $175 |
| Driver’s Physical | $150 |
| Travel Insurance Cancellation Form | $175 |
| Attending Physician’s Statement | $175 |
| Retirement Home Admission Forms | $175 |
| Special Authorization for Drug Coverage Form (non-ODB, private insurance) | $50 |
| CPP Narrative Medical Report | $115 ($200 minus the $85 Service Canada Stipend) |
| Guarantor Documents (i.e., for passports, birth certificates) | $75 |
| Other Simple Forms not Otherwise Specified | $50 |
| OCF-3 Disability Certificate | $260 |
| OCF-18 Treatment Plan | $280 |
| OCF-19 Determination of Catastrophic Impairment | $155 |
| OCF-23 Treatment Confirmation | $260 |
| Procedures: | |
| Ear Flushing (when not covered by OHIP) | $50 |
| Skin Lesion removal by liquid nitrogen (up to 5)
– Skin tag, wart, seborrheic keratosis Skin Lesion removal by liquid nitrogen (5 or more) |
$35
$55 |