Clinic Fees for Uninsured Services

Medical Exams Certificate of Fitness for School, Camp, Daycare, Etc. $25 for form only; $70 for full examination
Driver's License Medicals $80
Immigration Medicals $150 (does not include cost of lab work, x-rays, etc.)
(03A) Office Visit (if no AHC coverage) $35 - $60
(04A) Complete Physical Exam (if no AHC coverage) $80 - $110
Forms/Letters/Reports/Accident and Disability forms Minimum $65 (depending on complexity of form)
Physician Statements for insurance companies $80 - $200 (depending on complexity, etc.)
Medical-Legal Reports $250 per hour
Pregnancy Leave, U.I.C., Disabled Parking Forms Minimum $20
Pre-Employment Medical Exam and Form $80 - $150
Entry into LTC/Seniors Residence Form $25 - $55
Trustee/Guardianship Form $80
AISH Form $60
Return To & Absence From Work Forms Minimum $15

Procedures Wart treatments with Verucca Freeze $20 per treatment/wart
Circumcision $160
Flu Vaccines (if not meet public health criteria) $15
Other vaccines cost of vaccine + $30
Copy of Chart $25 for first 20 pages then an additional $0.25 per page thereafter
Vasectomy $125

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