Not all of the services that we offer are covered by the Alberta Health Care Insurance Plan (AHC).
If you have a form please check in with the back office once you have registered for your appointment with reception.
Each of the forms and services listed below are subject to a fee that must be paid by the patient in full PRIOR to seeing the physician for your appointment. These fees are per AMA guidelines and may be adjusted depending on the particular situation. As per CPSA guidelines physicians have 30 days to complete, after receiving the forms request.
Insurance forms and reports
Disability Benefit Reports
Attending Physician’s Statement
CRA Disability Tax Credit Form
General Insurance Eligibility Forms
AISH
School or work forms and reports
Sick Note
Return to Work
School Requested Forms & Reports
Certificate of Fitness (Summer Camp, School, Travel, etc.)
Pre-Employment/Periodical Health Exam (Uninsured)
E.I./Pregnancy Leave Forms
Medical fitness forms and reports
Driver’s Medical (any class)
Aviation Medical
Disabled Parking Placard
Seniors Residence Medical Reports (Lodge, Manor, etc)
Child Welfare Forms (Adoption/Foster Care)
Office procedures
Surgical excision of warts/moles (cosmetic)
Liquid Nitrogen (includes all treatments for affected area)
Other Non-surgical (cosmetic) procedures vary
BOTOX varies
**BOTOX for chronic headaches & hyperhidrosis is partially covered**
Photocopies and charts
If Requested by Insurance Companies/Third Parties
Patient Request (as per Alberta HIA regulations)
File Transfer to Another Clinic
Other fees
Travel Advice (fee is dependent on time and information required)
Phone/Fax Prescription Requests (only done in extenuating circumstances)
Missed Appointments (after 2 'no-shows' in a 12 month period)
Uninsured Office Visit
Uninsured Complete Visit