Forms/Chart Copies/Medicolegal Reports

Patient Fees – Uninsured Services

The Alberta Health Care Insurance Plan pays for many of the services you receive from your doctor. However, the government plan does not cover certain uninsured services.  Some are billed to lawyers, government agencies or others.  Some can be billed to you, the patient. 

You or a third party (such as your employer, insurance company or school) may request a letter, report, form etc from your physician. These services require time and the expertise of your doctor and staff. As a result, you or the third party will be billed a fee to cover these costs.

Any fee requested will be discussed with you before providing an uninsured service.  Payment will be expected when you receive this service.  To make other payment arrangements, please talk with your doctor or the staff.

We accept cash, cheque, debit, Visa, Mastercard and American Express. 

  Insurance form completion

 $75

  Medical report requiring review of chart and answers to specific questions

 $400

  Note for fitness to participate in sports/camps/activities

 $50

  Note or form outlying fitness to return to work, date/hours/capacity

 $50

  Employment Insurance (EI) form completion

 $50

  Disabled parking form completion

 $50

  Missed consultation appointment charge

 $100

  Copy of medical chart

 $25 + $0.25/page

 Medical Legal Report

 $450-625/hr

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