Non-Insured Fee’s
The current list of services are NOT covered by Manitoba Health and will be the responsibility of the patient to make payment unless otherwise specified.
The clinic does NOT direct bill 3rd party insurance companies unless otherwise informed.
The clinic accepts cash, debit, visa, MasterCard or cheque made payable to Bridgwater Medical Centre.
| SICK NOTE/WORK NOTES | $25 |
|
RETURN TO WORK FORM MODIFIED DUTIES FORM |
$40 $60 |
| PHYSIO / MASSAGE RX | $10 |
|
CHART TRANSFERS – FIRST 50 PAGES ($0.30 AFTER 50 + PGS) |
$25.00 |
|
PHYSICIANS LETTERS/CHART NOTES (1/4 PAGE) (1/2 PAGE) (FULL PAGE) |
$20 $30 $40 |
| PHYSICAL/FITNESS FORMS | $100 |
|
CERTIFICATE OF FITNESS FORMS (FOR SCHOOL/DAY-CARE/CAMP OR TRAVEL) |
$30 |
| MPI DRIVERS MEDICAL FORMS | $110 |
|
INSURANCE FORMS (FUNCTIONAL INQUIRY/HISTORY OF HEALTH &/OR RESULTS OF PHYSICAL EXAM) |
$150 |
| ATTENDING PHYSICIANS STATEMENT |
$90
|
| DISABILITY TAX CREDIT/DISABILITY | $150 |
| PARKING PERMIT/HANDI-TRANSIT | $30 |
|
OUT OF COUNTRY REGULAR VISIT PHYSICAL/PROCEDURE |
$50 $100 |
|
INJECTIONS TWINRIX JUNIOR 1ST VISIT (HEP A & B) TWINRIX ADULT 1ST VISIT (HEP A & B) TWINRIX JUNIOR 2ND & 3RD VISIT TWINRIX ADULT 2ND & 3RD VISIT GARDASIL (BORN AFTER 1997) SHINGLES |
$40
$80
$40 each
$80 each
$30 $30 |
|
MANTOUX FIRST VISIT SECOND VISIT |
$100 |
|
ZOSTAVAX II + INJECTION GARDASIL 9 + INJECTION (BORN BEFORE 1997) |
$237.89 $220.73 |
| Urine Dip | $10 |
| Pregnancy Test | $10 |
| Ear Flush | $30 for Both Ears/$15 for one Ear |
| Prenatal Visit | $100 including everything |
| IUD Insertion | $220 |
| Rx Refill | $20 |