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. If your Health Card is not valid, your appointment will not be covered by OHIP and therefore a cash fee will apply and be due at time of visit - see the list of fees below.

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 or by emailing the clinic using the email tab on this website

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 our office regarding the scheduling of a consultation appointment or diagnostic test. If you have not heard from our office within 4 weeks, please feel free to contact the office.

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

Test Results: We do not routinely call patients with normal test 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 email forms or make an appointment to drop off forms to be filled out by their Family Practitioner. Please make sure to complete your portion of the form prior to emailing or dropping off. There is a fee for the completion of forms(see fees listed below), fees are payable by cash or e-transfer.

Average Wait-time for Form Completion:

Dr. N. Alshakarji: 1-3days

Dr. D. Jayalath: 2 weeks minimum

Dr. A. Raouf-Alkadhimi: 1-3days

Dr. R. Abboud: 2 weeks minimum

WSIB Forms: Completion of WSIB forms are covered by WSIB

Uninsured Services: These services are not covered by OHIP. Theses services are billed directly to the patient and are payable by cash or e-transfer. Uninsured services include the completion of all notes, forms, letters and certificates; referrals for physio therapy, massage therapy and orthotics; as well as splints, tensor bandages and wart removal/skin tag 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, unless otherwise noted by the insurance company that payment is the patient's responsibility.

Payment Options: Cash or E-Transfer (the office can provide you with the specific email address for the e-transfer)

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

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

$ 60 Minor Assessment
$ 90 - 95 Intermediate Assessment
$ 210 - 215 Major Assessment

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 therefore 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

Uninsured Services

These services are not covered by OHIP.

Fees are payable by cash or e-transfer and are due at the time of the service.

Based on complexity - fees may fluctuate.

Fees are subject to change without notice.

Timeframe for Completion of Forms/Reports/Letters/Notes etc.:

Dr. Nather Alshakarji: 1-3 days

Dr. Ahmed Raouf-Alkadhimi: 1-3 days

Dr. Dhanya Jayalath: an appointment with Dr. Jayalath to review the form is required; then 2-3 weeks for completion

Dr. Rana Abboud: 2-3 weeks

Sandra Olanubi - N.P.: 1-5 days

$ 20.00 Note: Sick, Return to work, Free of Communicable Disease etc.
$ 20.00 Referral/Prescription for Massage Therapy, Physiotherapy, Orthotics and Back Brace for insurance coverage
$ 20.00 Medical Clearance for Dental Procedure
$ 20.00 CPP for Specialist
$ 40.00 Pre-Op Form (No longer covered by OHIP)

$ 25.00 Form/Letter for School, Camp, Daycare
$ 45.00 Form/Letter for Fitness for Pre-employment, Fitness Facility, Employee at a Medical Facility
$ 45.00 Abilities form for Workplace
$ 45.00 Employment Insurance Sickness Benefits - Medical Certificate

$ 80.00 Ontario Ministry of Transportation Driver's Medical Form/Physical
$ 150.00 Driver's Medical Form/Physical (ANY driver's medical form that is not 'Ministry of Transportation Ontario' Form)

$ 160.00 Attending Physician's Statement (APS)
$ 160.00 Insurance Certificate for Disability
$ 145.00 Insurance Certificate for Treatment Plan
$ 140.00 Insurance Certificate for Determination of Catastrophic Impairment
$ 160.00 Insurance Certificate for Treatment Confirmation
$ 260.00 Insurance Medical Examination

$ 83.00 Revenue Canada, Federal Disability Tax Credit Form
$ 55.00 Medical Certificate for Employment Insurance Compassionate Care Benefits
$ 45.00 Life Insurance Death Certificate
$ 80.00 Travel Cancellation Form
$ 55.00 Children’s Aid Society (CAS) Application for Prospective Foster Parent
$ 160.00 Citizen and Immigration Canada Medical Report for Immigration
$ 105.00 Request for Medical Information re: Applicants to the Armed Forces

$ 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)

$ 40.00 - 100.00 Skin Tag/Lesion Removal
$ 40.00 - 100.00 Wart/Corn Removal (wart removal on feet may be referred to a dermatologist)
$ 40.00 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.

$ 30.00 Arm Splint
$ 20.00 Suture Glue
$ 5.00 Finger Splint
$ 5.00 Tensor Bandage

$ 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)

$ 60.00 TB 1 Step (2 in office appointments are required, these are time specific appointments)
$ 90.00 TB 2 Step (4 in office appointments are required, these are time specific appointments)

Acton Medical & Urgent Care Clinic

Clinic Policies

​

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

​

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

$ 60 Minor Assessment

$ 90 - 95 Intermediate Assessment

$ 210 - 215 Major Assessment

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 therefore 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

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

$ 20.00 Referral/Prescription for Massage Therapy, Physiotherapy, Orthotics and Back Brace for insurance coverage

$ 20.00 Medical Clearance for Dental Procedure

$ 20.00 CPP for Specialist

$ 40.00 Pre-Op Form (No longer covered by OHIP)

​

$ 25.00 Form/Letter for School, Camp, Daycare

$ 45.00 Form/Letter for Fitness for Pre-employment, Fitness Facility, Employee at a Medical Facility

$ 45.00 Abilities form for Workplace

$ 45.00 Employment Insurance Sickness Benefits - Medical Certificate

​​

$ 80.00 Ontario Ministry of Transportation Driver's Medical Form/Physical

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

​

$ 160.00 Attending Physician's Statement (APS)

$ 160.00 Insurance Certificate for Disability

$ 145.00 Insurance Certificate for Treatment Plan

$ 140.00 Insurance Certificate for Determination of Catastrophic Impairment

$ 160.00 Insurance Certificate for Treatment Confirmation

$ 260.00 Insurance Medical Examination

​

$ 83.00 Revenue Canada, Federal Disability Tax Credit Form

$ 55.00 Medical Certificate for Employment Insurance Compassionate Care Benefits

$ 45.00 Life Insurance Death Certificate

$ 80.00 Travel Cancellation Form

$ 55.00 Children’s Aid Society (CAS) Application for Prospective Foster Parent

$ 160.00 Citizen and Immigration Canada Medical Report for Immigration

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

​

​

$ 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)

$ 40.00 - 100.00 Skin Tag/Lesion Removal

$ 40.00 - 100.00 Wart/Corn Removal (wart removal on feet may be referred to a dermatologist)

$ 40.00 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.

​

​

$ 75.00 Travel Consultation for 1 patient

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

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