FORMS and POLICIES
As a patient at our clinic you might be asked to fill out some forms. Below are copies of the most commonly used forms in PDF and Word format.
Health Questionaire
Privacy Policy
Punctuality and Delays
We kindly request that patients are punctual for all medical appointments. For physicals and prenatal appointments please arrive five minutes early. If one person is late we then run behind for the rest of the day. This causes other patients unnecessary delays and long wait times.
We know that we don’t always run on time, but we do our best to be as punctual as possible. There are often unexpected delays due to emergency phones calls, attending to deliveries, and complicated appointments requiring extra time.
If we all do our best, we will hopefully all be on time as often as possible.
Uninsured Services
Some medical services are not covered by MSP or insurance. The fees vary depending on the service. The most common uninsured services are listed here.
Fees for uninsured services
Vaccine injections: $40
Short forms: $40
Disability Tax Credit Forms: $120
Long forms: $120
Drivers physical: $248
Liquid nitrogen: $60 per unit
Mole removal: $120
Missed appointment: $50
Appointments for those without MSP: $60, $80 or $100 (regular, counselling, and physical)
Chart transfer: $30 for first 25 pages
* payment by cash, cheque or e-transfer to meadowbrook.family.practice@gmail.com
* payment required prior to service