Clinic Policies
 

Health Cards:  It is crucial that the office has accurate information on every patient.  Please bring your HEALTH CARD to EVERY appointment and walk-in clinic visit.

 

Missed appointment: 12-24 hours notice for the cancellation of an appointment is appreciated.  However, the office is understanding that emergencies due come up and notice can not always be given.

Scheduling of appointments:  Appointments can be made by calling the office at 519-853-4449 / 519-853-9997 or by emailing the clinic at actonmedical@cogeco.net

 

Medication Renewals:  see the Medication Renewal page

 

Referrals:  It can take 3-4 weeks or longer for a specialist's office or certain diagnostic testing centres to get back to us regarding the scheduling of an appointment. If you have not heard from us within 4 weeks, please feel free to follow-up with our office.

 

Pre-Op Forms:  No longer required for surgery and are therefor no longer covered under OHIP

 

Test Results:  We do not routinely call back normal results, nor is there a need to book an appointment to check these results UNLESS you have been specifically advised to do so.  If there is a concern about your results you will be contacted. All reports are reviewed by the doctor prior to filing.  However patients should feel free to contact the office at anytime regarding test results.

 

Forms:  Registered patients may drop off medical forms to be filled out by their Family Physician.  There may be a wait time of up to 2 weeks for the completion of the form(s) or longer based on the complexity of the form(s). There will be a fee for the completion of the form and a pre-payment in cash is required, please see the uninsured list below.

Uninsured Services:  These services are not covered by OHIP. Theses services are billed directly to the patient and are payable by cash.  Uninsured services include the completion of all notes, forms, letters and certificates; referrals for physio therapy, massage therapy and orthodics; as well as cortisone injections, splints, tensor bandages and wart removal etc.

 

Personal Life Insurance Forms: These are typically sent directly to the office by the Insurance Company. These are normally completed in 6-8 weeks, and the invoice is directly sent to the issuing Insurance Company.

Payment Options: Cash

 

A VALID Health Card is required for ALL visits at Acton Medical and Urgent Care.

If you DONT have a VALID Health Card a cash fee is required for ALL visits - See the fees listed below

MANY Red + White Health Cards have been cancelled by OHIP without patient's being aware - Contact a Service ON location to update your Ontario Health Card.  

 

Residents of Quebec do not have Health Coverage that is compatible with OHIP and therefor cash payment is required, ALL other provinces are covered with OHIP using their VALID Province Health Coverage Card

Patients who DONT reside in Canada are required to complete an Out-Of-Country Form and cash payment is required for the visit

  • $   45.00  Minor Assessment

  • $   75.00  Intermediate Assessment

  • $ 170.00  Major Assessment

 

The Type of assessment that will be charged is determined by the physician which is based on OHIP guidelines

 

Uninsured Services

 

These services are not covered by OHIP.  Fees are payable in cash and are due at the time of the service. 

Pre-payment is required for paperwork.

  • $   20.00  Note:  Sick, Return to work, Free of Communicable Disease etc.

  • $   28.00  Employment Insurance Sickness Benefits Medical Certificate

  • $   15.00  Referral / Prescription for Massage Therapy, Physiotherapy, Orthotics and Back Brace for insurance coverage

  • $   27.00  Form / Letter for School, Camp, Daycare

  • $   36.00  Form / Letter for Fitness for Pre-employment, Fitness Facility, Employee at a Medical Facility

  • $ 140.00  Attending Physician's Statement (APS)

  • $ 140.00  Insurance Certificate for Disability

  • $ 140.00  Insurance Certificate for Treatment Plan

  • $ 115.00  Insurance Certificate for Determination of Catastrophic Impairment

  • $ 140.00  Insurance Certificate for Treatment Confirmation

  • $ 230.00  Insurance Medical Examination

  • $   80.00  Driver's Medical / Ministry of Transport Form / Physical (Ontario)

  • $ 150.00  Driver's Medical Form / Physical (ANY driver's medical form that is not  'Ministry of Transportation Ontario' Form)

  • $   46.00  Revenue Canada, Federal Disability Tax Credit Form

  • $   53.00  Medical Certificate for Employment Insurance Compassionate Care Benefits

  • $   46.00  Life Insurance Death Certificate

  • $   37.00  Travel Cancellation Form

  • $   56.00  Children’s Aid Society (CAS) Application for Prospective Foster Parent

  • $ 134.00  Citizen and Immigration Canada Medical Report for Immigration

  • $ 105.00  Request for Medical Information re:  Applicants to the Armed Forces

  • $   20.00  Medical Clearance for Dental Procedure

  • $   20.00  CPP for Specialist 

  • $   40.00  Pre-Op Form

  • $   30.00  Copying/Transmission of Medical Record(s) (first 20 pages), $0.25 per page thereafter

  • $   18.00  PAP not covered by OHIP (additional processing fee is billed directly by Dynacare Laboratory)

  • $   41.00  Skin Tag Removal without Biopsy

  • $   71.00  Skin Tag Removal WITH Biopsy

  • $   20.00  Wart Removal, per wart (wart removal on feet are referred to a dermatologist)

  • $   75.00  Travel Consultation for 1 patient

  • $ 125.00  Travel Consultation for 2 patients (in same family), $ 30.00 for each additional family member

          (Travel consultation fee(s) include the initial consultation and follow-up appointment(s) to administer injection(s). 

           The travel consultation fee(s) does NOT included the cost of purchasing the injection(s) at a Pharmacy)

  • $   30.00  TB test 1 step

  • $   60.00  TB test 2 step

  • $   50.00  Cortisone Injection

  • $   30.00  Arm Splint

  • $     5.00  Finger Splint

  • $     5.00  Tensor Bandage

  • $   20.00  Ear Flushing/Wax Removal.....for 3 days prior to this appointment patients must administer 3 drops of mineral oil into the ears 5 times daily.

COMPLETION OF FORMS/REPORTS/LETTERS/NOTES MAY TAKE UP TO 2 WEEKS TO BE COMPLETED

(POSSIBLY LONGER, BASED ON THE COMPLEXITY OF THE FORM)

 If you have a medical emergency please call 911.

 

If you have any medical questions/concerns you can call 

Telehealth Ontario at 1-866-797-0000.