Medical Forms & Fees
Form Type
Fee
Appointment Needed
School/Camp Physical
$30.00
Admission to Day-care, Preschool, College/University
$30.00
Pre-Employment-Certification of Fitness
$40.00
Fitness Club
$40.00
Hospital/Nursing Home Employee Physical
$40.00
Driver’s Medical – All
$65.00
Federal Employee Absence Note (Blue)
$25.00
Pre-Adoption Exam for CAS
$240.00
Travel Cancellation Form
$40.00
Consult with Provider
Medical Certificate for EI Sickness Benefits
$45.00
Sick Note
$20.00
Disease/System Specific Questionaire
$100.00
UIC Disability/Maternity Certificate
$40.00
Insurance Medical Examination (Assessment and Report)
$260.00
APS (Attending Phsyciain’s Statement) $150 or MD hourly rate
$160.00
Disability Tax Credit
$80.00
Driver’s Medical with Examination
$150.00
Travel Medical Advice/Clearance
$75.00
Deployment Forms – Military
$100.00
Maternity Certificate/Form
$30.00
Certificate of Freedom from Communicable Diseases
$20.00
Consult with Provider
CAS Application for Prospective Foster Parent
$65.00
Medical Certificate for EI Compassionate Care Benefits
$65.00
Life Insurance – Death Certificate
$55.00
Employer – FAF – Return to work or to extend leave
$55.00