Screening Officer Form
$
40
and up
Featured
AISH Forms
$
150
and up
CPP Disability
$
100
and up
if any extra pages are needed $20 per page
CPP Pension Plan
$
100
and up
Featured
CRA Disability Credit Form
$
60
for the first page
and $20 per page thereafter
Pregnancy Test
$
5
Modified Duties Work Form
$
60
for the first page
and $20 per page thereafter
Featured
Letter for CRA for
Child Health Benefits
$
60
for the first page
and $20 per page thereafter
Print-out of Reports
¢
50
per page
APS Form
$
175
to $ 300
Featured
Pregnancy Leave and
EI Forms
$
60
for the first page
and $20 per page thereafter
Disabled Parking Authorization Form
$
50
Driver's Medical
$
70
Featured
Alberta Motor Vehicle Insurance
AB-1a Claim for Disability Benefits
$
75
AB-2 treatment Plan
$
125
Featured
AB-3 Progress Report (only to be completed on request of insurer)
$
100
AB-4 Concluding Report
$
100
Featured
Certified Examiner Opinion
$
275
250 +
Satisfied Patients315 +
Health Sections180 +
Kinds of Research250 +
Award WinningMeet the Experts
Our Experienced Team
Family Physician
Dr. Assumpta Efobi
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| UNINSURED SERVICES PRICE LIST | EFFECTIVE JANUARY 01/2022 |
| Out of Province Visit (Quebec Patients/ No PHN) | $60.00 |
| CPX | $160.00 |
| PAP Only | $90.00 |
| CPX + Pap | $190.00 |
| Out of Country | $160.00 |
| CPX | $250.00 |
| PAP Only | $120.00 |
| CPX+Pap | $290.00 |
| Completion of Forms | $40 for 1st page and $20 for each subsequent page |
| Forms and Exams | |
| Sick Note | $20.00 |
| Disability Parking Form | $40.00 |
| Drivers Medical 75 and Under | $150.00 |
| 75 and Over | $100.00 |
| No Show Fee | $50.00 |
| Chart Transfer | $60.00 + |
| Nitrogen Treatments | One time fee per wart $20.00 |