Charleswood Clinic
Charleswood Clinic
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    • Home
    • Book An Appointment
    • Patient Portal
    • Doctors & Staff
    • Uninsured Services
    • Smartphone App
    • Clinic Policies
    • Gallery
    • Careers
  • Home
  • Book An Appointment
  • Patient Portal
  • Doctors & Staff
  • Uninsured Services
  • Smartphone App
  • Clinic Policies
  • Gallery
  • Careers

Uninsured Services Price List

Physical Exams & Office Visits Not Covered by MHSC

Work Physical Exam & Form

$125

Adoption Physical Exam & Form

$125

Sport Physical Exam & Form

$125

Private Surgery Pre-Op Exam & Form

$125

MPI Driver's Physical Exam & Form

$125

Travel Health Office Visit

$50

Patients Without Valid MHSC Coverage

Initial Visit

$125

Follow-Up Visit

$60

Forms

Sick Note

$25

Doctor's Certification Note

$25

Includes notes for massage therapy, physiotherapy, chiropractic therapy, orthotics, compression stockings etc. 

Disability Insurance Claims Form

$80

Modified Duties/ Company Work Form

$80

Parking Permit

$50

Handi-Transit Form

$50

CRA Disability Tax Credit Form

$150

MPI Alcohol/Drug Reporting Form

$50

RCMP/ WPG Police Medical Health Form

$100

Camp/School Form

$60

Travel Cancellation Form

$50

School Immunization Form

$60

NIHB Form

$30

Proof Of Death Form

$50

Mantoux

TB One-Step (Injection Only, Form Extra)

$60

TB Two-Step (Injection Only, Form Extra)

$120

Immunizations Not Covered by MHSC

Hepatitis A (Injection Only)

$30

Hepatitis B (Injection Only)

$30

Twinrix (Combined Hepatitis A/B Injection Only)

$30

HPV Vaccine & Injection (Gardasil)

$190

Zostavax Vaccine & Injection

$225

Shingrix Vaccine & Injection

$325

Prevnar 13 Vaccine & Injection

$150

All other injections not covered by MHSC

$30

Miscellaneous

Private EKG

$30

Transfer of Chart

$50

Bloodwork for Third Party

Lab Rate

Manitoba Health does not pay for medically unnecessary bloodwork requested by third parties. 

Missed Appointments

Please note, after the first no show, you will not be charged but will be made aware of the cancellation policy and associated fees. You will be charged for all subsequent no-shows, and these fees must be paid prior to booking the next appointment. Three or more no shows may result in termination from the practice.

Missed Regular Appointment

$60

We require a minimum of 24-hour notice of cancellation of an appointment. Cancellations are easiest done online via the patient portal link on our website, www.charleswoodclinic.ca. As well, you can cancel an appointment directly from the notification sent to your SMS and/or e-mail address when you initially booked your appointment. Additionally, you may cancel in person, via telephone or fax.  

Missed Physical Exam or Specialty Appointment

$120

We require a minimum of 24-hour notice of cancellation of an appointment. Cancellations are easiest done online via the patient portal link on our website, www.charleswoodclinic.ca. As well, you can cancel an appointment directly from the notification sent to your SMS and/or e-mail address when you initially booked your appointment. Additionally, you may cancel in person, via telephone or fax. 

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