Courtesy & Mutual Respect
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Lancaster Medical Family Practice is committed to providing a safe, welcoming, and supportive environment for all of our patients. In return, we expect our patients to treat our entire clinic team with courtesy and mutual respect.
We operate as a unified healthcare team. This means that our front desk staff, nurse, and physicians work closely together to coordinate your care. Please be advised that any improper behaviour, aggressive language, or disrespect directed toward our administrative staff is considered direct disrespect to our physicians.
We maintain a strict zero-tolerance policy for abuse, harassment, or rudeness of any kind. Disrespect toward any member of our clinic team will not be tolerated and is grounds for immediate and permanent dismissal from our practice.
Cancellation & Missed Appointment Policy
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When you book an appointment, that time is reserved exclusively for you. Out of respect for your physician, our staff, and other patients who may need medical care, we require at least 24 hours’ notice to cancel or reschedule an appointment. Please be advised that missed appointments or cancellations made with less than 24 hours’ notice are subject to a $40.00 fee.
We offer two easy ways to cancel or reschedule your appointment ahead of the 24-hour window:
- By Phone: Call our office and leave a voicemail (simply press 2 after the initial prompt).
- Online: If you have consented to email communication, you will receive reminders 4 days and 2 days prior to your visit. You can easily cancel your appointment directly through the link provided in those emails.
Outside Use/Walk-In Clinic Policy
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We have a strict policy against using outside walk-in/urgent care clinics (e.g., KW Urgent Care, Onyx, etc). As a rostered patient, visits to external clinics result in financial penalties for your physician and disrupt your continuity of care.
Please use our On-Call/After Hours Service or Health811 for your urgent care needs.
If you have an emergency, please call 911 or present to your nearest emergency department.
Prescription Renewal Policy
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To ensure your medications remain safe, effective, and appropriate for your current health needs, an appointment with your physician is required for all prescription renewals. We kindly ask that you provide at least three weeks’ notice when booking your renewal appointment so you do not run out of your medication.
When should I book my appointment?
- Check your bottle: The best time to call is when you pick up your medication and notice “0 repeats”, “R=0”, or “Refills: 0” on the pharmacy label.
- Book before you leave: You can also easily schedule your next renewal appointment with our front desk before leaving the clinic!
Pharmacy Faxes & Renewal Fees
Please avoid asking your pharmacy to fax prescription renewal requests directly to our office. If your doctor needs to send a prescription directly to your pharmacy without an appointment (either by your request or because an appointment was not booked with enough notice), an automatic $25.00 fee will apply.
*Please note: Paying the fee in lieu of an appointment is strictly subject to your physician’s medical discretion and is not permitted for all types of medications.
Uninsured Services & Fee Guide
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Some services provided by your Family Physician are not covered by OHIP (Ontario Health Insurance Plan). The fees listed below are based on the Ontario Medical Association’s (OMA) suggested fee guide. Many of our clinic’s fees are actually set lower than the OMA suggestions, and none exceed them.
When requesting forms to be completed, please read the document in its entirety and fill out ALL portions required by the patient (e.g., your name, employee number, last date worked, and consent for release of medical information) BEFORE dropping it off. Failure to do so will delay the completion of your form. Thank you for your cooperation!
Notes, Forms & Certificates
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Please note: Form completion may take up to 30 days. An assessment fee may be charged when an assessment is not medically necessary.
General Notes & Physicals
| Sick Note (return to work/school/daycare or free of communicable disease) | $25.00 |
| Physicals for school, daycare, pre-school, camps, or post-secondary ‡ | $50.00 |
| Physicals for pre-employment certification or fitness clubs | $50.00 |
| Physicals for hospital or nursing home employees | $50.00 |
Disability & Insurance Forms
| Medical Certificate for EI Benefits (Sickness, Maternity, Parental, Compassionate) ‡ | $35.00 |
| School Accommodations Form | $50.00 – $100.00 |
| Disability Form for Work, Private Insurance, Modified Duty, or Return to Work | $50.00 – $150.00 |
| CRA Disability Tax Credit Certificate (Form T2201) ‡ | $150.00 |
| Attending Physician’s Statement | $160.00* |
| Clarification Report / Full Narrative Report for Insurance | Hourly Rate |
*Or Physician’s hourly rate depending on complexity.
Government & Specialized Forms
| Travel Cancellation Insurance Form ‡ | $150.00 |
| Special Authorization for Drug Coverage (non-ODB, private insurance) | $50.00 |
| Retirement Home Admission Forms | $100.00 |
| Driver’s Medical Follow-Up Assessment Form (e.g., Diabetes, Cardiovascular) ‡ | $100.00 – $200.00 |
| Driver’s Medical Examination ‡ | $240.00 |
| CPP Medical Report for Disability Benefit (SCISP-2519) | $200.00 (Up to $85.00 covered) |
| CPP Disability Narrative Medical Report | $150.00 (Up to $150.00 covered) |
| CPP Disability – Medical Appeal & Medico-Legal Letters ‡ | Hourly Rate |
Diagnosis, Counselling & Treatment
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| Prescription Renewal Without a Visit (Requested by patient via phone/portal or by Pharmacist via fax) |
$25.00 |
| Letter for Massage, Orthotics, or Medical Devices | $25.00 |
| Vaccine Administration Fee for Immunizations not covered by OHIP (e.g., travel) | $30.00 |
| Ear Flushing (when not covered by OHIP) | $50.00 ($25.00 for age 65+) |
| TB Skin Test for Employment (incl. assessment, test & note/form) | $75.00 |
Cosmetic Procedures ‡
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Skin Lesion Removal (e.g., hand warts, keratoses, skin tags) Using liquid nitrogen or cantharidin |
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| • 1 to 2 lesions/treatments | $35.00 /visit |
| • 3 to 4 lesions/treatments | $50.00 /visit |
| • 5 to 12 lesions/treatments | $65.00 /visit |
| • 13+ lesions/treatments | $80.00 /visit |
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Skin Lesion Removal (e.g., skin tags) Using a scalpel +/- freezing/cautery (no sutures) |
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| • 1 to 4 skin tags/lesions | $75.00 |
| • 5 to 8 skin tags/lesions | $100.00 |
| • 8 to 12 skin tags/lesions | $125.00 |
| • 13+ skin tags/lesions | $150.00 |
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Benign Skin Lesion Removal (e.g., moles, cysts) Excision including freezing/suturing |
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| • Per procedure | $150.00 – $200.00 |
Administrative Services (Medical Records)
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| Request for a copy of test results (emailed at patient’s request) | $10.00 |
| Request for a copy of an immunization record | $25.00 |
| Electronic Transfer of Chart (Entire chart exported to a CD or USB drive as a password-protected PDF) |
$30.00 |
| Photocopying, Printing, or Faxing Individual Medical Records (When done at the patient’s request) |
$30.00 (First 20 pages, +$0.25/page after) |
| Physician Review of External Records (Reviewing results of testing done elsewhere, e.g., abroad or private testing) |
$45.00 (Per 15 min, after first 15 min) |
Other Administrative Fees ‡
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| Courier or Registered Mail Delivery | $5.00 – $10.00 (Or at cost) |
| Replacement Fee for lost/misplaced prescriptions or test requisitions | $10.00 |
| Re-booking Fee for missed tests or specialist appointments | $10.00 |
| Appointment Reminder Fee when requested/required (e.g., telephone) | $20.00 |
| Missed Appointment Fee (without at least 24 hours’ notice) | $40.00 |
| Non-Sufficient Funds (NSF) Cheque | $45.00 |
† Please note that this list is not exhaustive and all fees are subject to change. OMA suggested rates have been rounded up to the nearest $0.05 or $5.00. These fees apply to uninsured services of “average” complexity. Depending on your individual circumstances, additional fees may apply.
‡ Subject to HST. 13% HST is included where noted.
Note: All medical services for injuries arising out of and in the course of the patient’s employment may NOT be billed to OHIP, and will be billed to the patient directly (e.g., if a patient chooses not to report their workplace injury to WSIB).

