Page 1 of 1

https://static.wixstatic.com/media/133941_2b7e50708d8c46b795d0029ac3636176~mv2.png/v1/crop/x_72,y_1116,w_3528,h_1002/fill/w_315,h_89,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/Health%20FIrst%20Medical%20clinic%20logo%20HD.png

Uninsured Services 2025

Service Plan Options for Seamless Payment (Powered by Carealy)
Attending Physician Statement insurance forms 💊 | $180.00 & up
Copy of chart notes (printed) | $30
Attending Physician Statement insurance forms | $180.00 & up
Copy of chart notes (printed) | $30
CRA Disability Tax Credit application 💊 | $169.50
Doctors note (sick leave/back to work/daycare/insurance) | $30.00
Ear syringe | $34.00
Forms for pre-employment certification/fitness club/hospital/nursing home | $56.50
Forms for school/camp/volunteer | $40.00 & up
Forms for work/employment | $50.00 & up
Functional ability forms (non-WSIB) | $113.00
Liquid Nitrogen Treatment (per spot) | $25.00
Massage/Physiotherapy/Chiropractor/Orthotics prescription | $30.00
Missed Appointment without 24hr notice | $56.50
Missed General Assessment without 48hr notice | $113.00
MTO driver's medical exam 💊 | $150.00 & up
Prescription Renewal without an appointment | $25.00
Printing of forms | $5.00
Special authorization form for private drug coverage | $40.00 & up
TB skin test when not for medical necessity + form | $56.50
Transfer of medical records | $45 (CD)

Annual Fee Options

* fee covers the items above (within reason) ** Valid for 1 year from the date of purchase
Annual Fee Options
A
B
C
Untitled checkboxes field
Includes children age 19 or younger living at the same address.
💊 This item is not fully covered by the annual fee (50% discount will be applied)
Fees align with rates recommended by the Ontario Medical Association and are subject to change.
As per CPSO third party policy, forms will be completed and submitted within 45 days of acceptance and require an appointment unless otherwise specified. A rush fee might apply if required within a specific time frame.
https://storage.tally.so/68952d76-d43f-49f6-b485-9b9f1d761892/QR-code-Health-First-Medical-Clinic-.png