Name: Postpartum Mood & Anxiety Disorder (PMAD) Group
Start: 2023-10-05T10:30:00-04:00
End: 2023-10-05T12:00:00-04:00
Location: Two Rivers Family Health Team

Hespeler Medical Clinic

Un-Insured Services not covered by OHIP

MOT PHYSICAL + FORM	$250.00
MISSED APPOINTMENT – ROUTINE VISIT	$37.00
MISSED APPOINTMENT – PHYSICAL/COUNSELLING	$68.00
PRESCRIPTION RENEWAL WITHOUT VISIT	$20.00
BACK TO WORK/SCHOOL NOTE	$25.00
PRESCRIPTION FOR MASSAGE/PHYSIO/CHIRO	$25.00
FORMS FOR CAMP/SCHOOL	$32.00
DISABILITY TAX CREDIT FORM (T2201)	$83.00
TRAVEL CANCELLATION INSURANCE FORM	$43.00
LIFE INSURANCE/DEATH CERTIFICATE	$54.00
PRE-EMPLOYMENT FORMS	$42.00
INSURANCE MEDICAL	$260.00
EMPLOYMENT SICK BENEFIT FORMS (INS5140)	$50.00 – $100.00
APPLICATION FOR FOSTER PARENT FORM	$65.00
DISABILITY CERTIFICATE (OCF3)	$160.00
CERTIFY FREE FROM COMMUNICABLE DISEASE	$22.00
TRANSFER OF MEDICAL RECORD – PAPER COPY	$35.00 1ST 20 PAGES THEN $0.30/PAGE
TRANSFER OF MEDICAL RECORD – ELECTRONIC/CD	$35.00
FORMS FOR INSURANCE/LEGAL	Per Physician Consideration

Hespeler Medical Clinic

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Un-Insured Services not covered by OHIP