At Cobourg Care Clinic, many medically necessary physician services are covered by the Ontario Health Insurance Plan (OHIP). However, administrative services, medical forms, reports, and specific examinations are non-insured and billed directly to the patient or third party.
Established with reference to Ontario Medical Association (OMA) guidelines.
Convenient payment via Cash and e-Transfer at time of service.
Official WSIB Functional Abilities Forms (FAF) are billed directly to WSIB without patient fee.
Effective & updated for Cobourg Care Clinic patients.
| Service | Category | Fee (CAD) |
|---|---|---|
Sick Note / Fit-to-Return-to-Work or School Note Standard note verifying medical absence or fitness to return to work/school. | Notes & Forms | $35 |
Completion of Medical Forms – daycare, school, camp, etc. Administrative form completion for educational institutions, daycare, or youth camps. | Notes & Forms | $35 |
Immunization Form Completion Verification and completion of official immunization history records. | Immunizations & Tests | $35 |
Extended Sick Note / School Excuse Note Beyond 3 Days Detailed medical note for prolonged illness requiring extended leave beyond 3 consecutive days. | Notes & Forms | $50 |
Adoption / Parental Leave Forms Medical evaluation and documentation required for adoption or specialized parental leave applications. | Notes & Forms | $50 |
Travel Consultation Pre-travel health risk assessment, advice, and vaccine recommendations. | Consultations & Exams | $50 |
Disability Tax Credit Certificate (T2201) Detailed CRA medical form completion for disability tax credit eligibility assessment. | Reports & Certificates | $100 |
Driver's Medical Examination (when not OHIP-covered) Comprehensive driver's licensing medical assessment when administrative/non-insured. | Consultations & Exams | $150 |
Attending Physician's Statement (APS) Comprehensive physician statement for insurance claims, disability, or legal purposes. | Reports & Certificates | $150 |
Third-Party Medical Report – insurance, employment or legal In-depth medical status report requested by third parties including insurers, employers, or legal representatives. | Reports & Certificates | $160 |
Copy of Medical Records Processing, retrieval, and printing/copying of personal medical health records. | Administrative & Records | $30 admin + $0.30/page |
Ear Wax Removal – One Ear Clinical ear irrigation or manual wax removal procedure for one ear. | Clinical Procedures | $25 |
Ear Wax Removal – Both Ears Clinical ear irrigation or manual wax removal procedure for both ears. | Clinical Procedures | $50 |
Firefighter's Physical Examination Specialized occupational physical fitness examination for active or applicant firefighters. | Consultations & Exams | $150 |
1-Step TB Skin Test Single-step Mantoux tuberculin skin test required for employment or school entry. | Immunizations & Tests | $70 |
2-Step TB Skin Test Two-step baseline Mantoux tuberculin skin test for healthcare or specialized employment requirements. | Immunizations & Tests | $100 |
Standard note verifying medical absence or fitness to return to work/school.
Administrative form completion for educational institutions, daycare, or youth camps.
Verification and completion of official immunization history records.
Detailed medical note for prolonged illness requiring extended leave beyond 3 consecutive days.
Medical evaluation and documentation required for adoption or specialized parental leave applications.
Pre-travel health risk assessment, advice, and vaccine recommendations.
Detailed CRA medical form completion for disability tax credit eligibility assessment.
Comprehensive driver's licensing medical assessment when administrative/non-insured.
Comprehensive physician statement for insurance claims, disability, or legal purposes.
In-depth medical status report requested by third parties including insurers, employers, or legal representatives.
Processing, retrieval, and printing/copying of personal medical health records.
Clinical ear irrigation or manual wax removal procedure for one ear.
Clinical ear irrigation or manual wax removal procedure for both ears.
Specialized occupational physical fitness examination for active or applicant firefighters.
Single-step Mantoux tuberculin skin test required for employment or school entry.
Two-step baseline Mantoux tuberculin skin test for healthcare or specialized employment requirements.
Payment for uninsured services is generally required at the time the service is provided or when the completed document is collected.
Patients are encouraged to confirm the applicable fee with our reception team prior to requesting a form, report, or exam.
Fees may vary for unusually complex requests requiring significant extra physician time. You will be advised before work is completed.
Everything you need to know about OHIP coverage, WSIB forms, driver's physicals, and third-party billings.
The fees listed above apply to uninsured services and are subject to change. Cobourg Care Clinic's uninsured-service fees are established with reference to applicable professional requirements and recommendations from the Ontario Medical Association (OMA). Where a service is insured by OHIP, WSIB, or another responsible payer, Cobourg Care Clinic will not charge the patient an uninsured-service fee for the same insured service.