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Filling Out a Medical Form

Annual (Block) Fee


OHIP does not pay for all services that you request from your doctor. These services include prescription renewals by phone or fax, insurance forms, sick notes, and others listed below. Services that OHIP does not pay for are called "uninsured services". 

You have the option to pay for each service individually at the time it is provided, or choose to pay an all-inclusive annual fee. The fees contained in the list below are based on the Ontario Medical Association's suggested fees as found in the OMA Physician's Guide to Uninsured Services.


The Annual Fee for individuals is $150 and for families is $250.

All uninsured services must be paid in full when rendered. You will receive a receipt for tax purposes following payment. Please note that our office accepts cheques, credit card and Interac payments (

Complete this form to opt into the block fee program. To pay online visit the payment page 
and email the form to

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