Fees not covered by MSP include the following:
Additional Fees:
Forms
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Insurance company disability/travel/time off (short form) $125.00
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Insurance company disability/travel/time off (long form) $165.00
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School/work time off (short note) $15.00
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School/work time off (more extensive note) $35.00
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Government UIC $35.65
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Employers work capability form $139.00
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Income tax disability (Short form) $120.00
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Income tax disability (Long form) $159.00
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SPARC form $25.00
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Handidart Application $25.00
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Nursing home registration / administration $75.00
Examinations
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Complete Physical $150.00
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Drivers License full exam (other than eyes) $95.00
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Drivers License Medical Exam and Report (DMER) $110.00
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Diabetic driver examination and report (DDR) $110.00
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Participatory Fitness for sports team/camp $55.00
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Industrial first Aid limited exam $110.00Treatments:
Treatments
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Liquid Nitrogen $35.00
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Excision Mole (cosmetic) – facial $200.00
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Excision Mole (cosmetic) – non facial $135.00
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Excision no suture $85.00
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Joint injection/Bursa injection $15.00
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Prescription renewal in patient’s absence $15.00

