Medical Forms/Reports
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Driver's Medical
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Certificate of Fitness (summer camp, football, scuba diving, etc)
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Form only
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Form Requiring Exam
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Adoption/Foster Parents Medical Report
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AISH Application
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Seniors Residence Admission Medical
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Pre-Employment Medical
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Third Party Requested Letter
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Office Visits for Out of Country Patients
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Sick/Absence Note or Physiotherapy/Massage Note
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Rx refill by Phone/Fax (select cases)
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Legal fees (MUST DISCUSS PRIOR)*
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Independent Medical Exam (MUST DISCUSS PRIOR)*
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Proof of death
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Ministry of Transportation or Industrial Health
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Veteran's Affairs
Insurance and Disability
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Attending Physician's Report* / General Eligibility
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Disability Forms*
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Form only
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Form requiring exam (MOST COMMON)
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Disability Tax Credit Forms*
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Blue Cross Authorization Form
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Handicap Parking Permit Form
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Unemployment Form
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Pregnancy Leave
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Pre-Operative Physicals (typically performed by surgeon)
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Special Authorization Forms
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Capacity and Guardianship
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Other Forms
Chart Request/Transfer
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Basic fee of $25.00 and $0.05 per page
These fees are within the guidelines recommended by the Alberta Medical Association
* Please be aware legal and insurance fees are often quite expensive and therefore should be discussed prior to completion. These documents WILL NOT BE COMPLETED UNTIL PAYMENT RECEIVED, even if that payment if from your lawyer/insurer
Please be aware that fees from patients outside of Canada may incur 3-5x typical costs, due to increased time, difficult, and liability for providing care for same. Fees must be agreed upon prior to care. THIS INCLUDES THE UNITED STATES.
$100
$55
$100-150
$60
$100
$75
$300
$200-500
$80
$30
$50
Variable
Variable
$100
$400
$100
$350
$100
$200
$100
$35
$75
$100
$80
Variable
$55
$Up to 700
$20 and up