NOTICE TO CLINIC PATRONS
SERVICE
Effective February
2017 the following fee
schedule will be in
effect at the Nanton
Community Health
Centre for the
following requested
uninsured services.
Where a dollar range
is indicated the
charge will be
determined by the
complexity of the
request.
FEE
General Insurance Eligibility
$100 - $200
Attending Physician’s Statement
$90
Disability Benefit Report
Form Completion ONLY
Examination and Form
$30
$100
Third-party Requested Letters
$180
Certification of Fitness for
School
$30
School Requested Forms
& Reports
$40
Sick Note (NOTE ONLY)
$30
Certification of Fitness for
Summer Camp, Day Care, Air
Travel, etc. (FORM ONLY)
$30
Senior’s Residence
Medical Report
$70
Disabled Parking Authorization
$40
Driver’s Medical
(74.5 years & under)
$90
Application for Trustee or
Guardianship
$100
Back to Work Note
$30
Injection (i.e. Travel
Vaccinations)
$20
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