top of page

Forms Fees

Most forms are not covered by OHIP and a fee will be charged for its completion.

Please read below for more information on pricing and instructions for form completion.

​​​

Instructions for Form Requests

Please complete the following steps before your appointment:

  1. Read the entire form and prepare answers for all questions.

  2. Fill out all information required by you (i.e. personal information, your signature, etc.). Do not fill out the sections meant for the doctor to complete.

  3. Submit the pre-filled form via our Contact Form at least 48 hours before your appointment, or bring the form with you if attending in person.

Processing Time

Please allow 3-7 business days for the form to be completed. If the form is urgent, please call our clinic and we will do our best to accommodate your request.

Pricing

The exact fee will be provided upon completion. Fees are dependent on the complexity and requirements of the form.

See below for approximated rates for common form requests.

Sick Note, Daycare Note, or Return to Work Note
$25.00
Driver's Medical Exam (Assessment + Form)
$200.00
Pre-Operative Assessment (Assessment + Form)
$100.00
Insurance Medical Exam (Assessment + Form)
$200.00
Physicals for School/Camp/Daycare/Education
$32.50
Physicals for Employment
$43.25
Attending Physician's Statement (i.e. Life & Health Insurance)
$160.00
OCF-3 Disability Certificate or OCF-18 Treatment Plan
$164.00
OCF-19 Determination of Catastrophic Impairment
$136.00
OCF-23 Treatment Confirmation
$163.00
CRA Disability Tax Credit Certificate (for T2201)
$150.00
CPP Narrative Medical Report
$150.00
Medical Report for CPP Disability Benefit
$85.00
Travel Cancellation Insurance Form
$44.00
Application for Accessible Parking Permit
No Charge
Accessible Transit Eligibility Application Forms (i.e. Wheel-Trans)
No Charge
Children's Aid Society Forms (on behalf of the child)
No Charge
Canadian Passport Application
No Charge
Ministry of Health Forms (i.e. Assistive Devices, etc.)
No Charge

© 2024 BY CITRUS MEDICAL CENTRE

bottom of page