COST OF UNINSURED SERVICES

FORMS

Sick Note $20
Doctor’s Note (for massage therapy, medical supplies, etc.) FREE
Disability Insurance Claim Form $20/page
Modified Work Duty Form $20/page
Parking Permit $30
Handi Transit $30
Disability Tax Credit $60
RRCC/School Forms $100
Preop Physical Exam Form Fee $30
MPI Alcohol Reporting Form $20

COMPLETE PHYSICALS NOT COVERED BY MHSC

For Employment Purposes $100
Private Physical $100
Private Preop Physical $100
Driver’s Physical $100

MANTOUX

Includes all Visits, Forms, Results and Mantoux Injections $200

IMMUNIZATIONS

Adult Flu Shot FREE
Children Flu Shot FREE
Hepatitis B $30
Hepatitis A $30
Twinrix $30
All Others Not Covered by MHSC $30

PATIENTS WITHOUT VALID MHSC COVERAGE

Out of Country $100-200
Manitoba Residents $50-100

OTHER ITEMS NOT COVERED BY MHSC

Photocopies $1/page
Private EKG $15
Transfer of Charts $25 and up