COVID-19 - Resources

Appointments:Book online or call 519-570-1655

Appointments:Book online or call 519-570-1655

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    • Home
    • Our Team
    • Booking Online
    • After Hours
    • Patient Resources
      • Ticks & Lyme Disease
      • Covid-19
      • Flu Vaccine Clinics
      • School Vaccinations
      • Health Connect Ont.-THAS
      • Mental Health
      • Wellness
      • Handouts
      • Public Health
      • Health Card Renewal
    • Visit Preparation
    • Office Policies
    • Email Policies
    • Annual Fee
    • Annual Fee Enrollment
    • Annual Fee Form
  • Home
  • Our Team
  • Booking Online
  • After Hours
  • Patient Resources
    • Ticks & Lyme Disease
    • Covid-19
    • Flu Vaccine Clinics
    • School Vaccinations
    • Health Connect Ont.-THAS
    • Mental Health
    • Wellness
    • Handouts
    • Public Health
    • Health Card Renewal
  • Visit Preparation
  • Office Policies
  • Email Policies
  • Annual Fee
  • Annual Fee Enrollment
  • Annual Fee Form

Annual Fee and Uninsured Services

The Ontario Health Insurance Plan (OHIP), while extensive in coverage does not cover all services. In accordance with the Ontario Medical Association's guidelines, fees will be charged for all uninsured services.  


For your convenience Greenbrook Family Medical provides the potential cost saving option of subscribing to an ANNUAL FEE. Patients who subscribe to the Annual Fee Plan will receive the services covered by the plan at no additional cost (see below).  The Annual Fee is not obligatory. Patients who do not enroll will be asked to prepay  for all uninsured services (individual consideration will be given if these fees represent a financial burden to you - please discuss with your physican).


Our annual fee Premium Coverage Plan has expanded to cover more services than ever before.  This premium coverage plan now includes both clinical services not covered by OHIP (wart removal, pregnancy tests, ear syringe, TB skin tests) as well as covering fees for prescription renewals (normally $30 per medication) and most doctor’s notes (including the disability tax credit form). 


Annual Fee: Now thru Dec 31, 2025:

INDIVIDUAL: $150.00


Subscribe to Annual Fee

If you wish to subscribe to our Annual Fee, please complete the form and you will be sent an annual invoice automatically.

Enroll in Annual Plan

Payment Options for Uninsured Services:

  1. Debit / Credit Card.
  2. Cheque payable to your physician (for Dr. Kaphengst's patients, please make cheques out to Greenbrook Family Medical)
  3. eTransfer to GreenbrookFamilyMedicalCentre@gmail.com. Please use the password Greenbrook. In the message, provide your invoice number (for example: SE12345). Be aware that it may take up to 30 days for your etransfer to be processed.

Services Covered by the Annual Fee*

PAY-PER-SERVICE :

Services not covered by OHIP

Prescription Renewal 

(by phone/fax or electronically) /medication  $30.00 

   

 Sick Note / Back to Work Note                             $30.00 

 

Missed Routine Appointment                              $40.00 

Missed Extended Visit                                              $75.00 

 

TB Skin Test - one step / two step                   $40   / $80

 

Faxing and Photocopying at the 

patient's request per page (test results)           $5.00 


Add a footnote if this applies to your business

Uninsured Services Not Covered by Annual Fee/OHIP continued

 Transfer of Medical Record pages 1-5                    $30.00 

 Each page thereafter (plus cost   of USB)                $0.25 

 Coping   chart on to USB                                        up to $60.00

 

Certification  of Fitness

 -to travel                                                                          $40.00 

 -for school/camp                                                         $40.00 

-for employment /health status                            $40.00 

 


     

Referral   Note for Chiropractor                               $30.00 

Physiotherapy, Massage, Chiropody,

Orthotics                                                                           $30.00 

Compression Stockings, 

other therapies                                                              $30.00 

Medical devices not covered by OHIP                  $30.00 

Medication authorization form

 for insurance                                                                  $30.00 

     

Travel Insurance Forms                                          $50 minimum

Trip Cancellation Forms                                            $50.00 

     

Driver's Medical Examination & Form                  $165.00 

 

Rev. Canada/Federal Disability Tax Credit        $150.00 

 

Short Term Disability form                                         $50.00 

 

CPP Disability                                                                 $100.00 

 

Other forms not covered by third party    $35.00 to $95.00

Add a footnote if this applies to your business

     

Uninsured Vaccination (per injection)                $30.00 

Lost blood work

other testing requisition replaced                        $10.00 

Immunization Record Replacement                    $25.00 

     

Wart removal (per lesion/wart)                              $30.00 

 

Long distance charges to family/consulting    

physicians at the patient’s request 

(per call)                                                                            $20.00

 

Ear Syringing                            $30 for one ear, $40 both

 

Urine Pregnancy Test                                                  $10.00 


421 Greenbrook Drive, Kitchener, Ontario N2M 4K1

Phone:  519-570-1655

Fax:  519-570-3477


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