The doctors get many forms every day from employers, insurers, government, schools, lawyers, etc.  These forms take up a significant portion of the doctors’ and staffs’ time and resources.  Fees for forms and supporting documents are posted in the office.

 

By providing us a form to fill, you agree to our fee policy and allow us to disclose the information to the requesting party. You may withdraw your consent to share the form to the requesting agency at any time, but the fee will be still due if the form has already been completed when you withdraw the consent.

 

The doctors will write the requested opinions/information on the form, but the requesting party decides how the information will be used (e.g. just because the doctor fills out an insurance certificate and you paid for the form, does not mean you will be granted the insurance benefit - that decision is up to the insurance company).

 

If you have a form for your doctor to complete, please provide two copies of the form:
 

1. Copy A: you complete your portion of the form only (e.g., your demographic information, signature, etc.) but leave the rest of the form blank.

2. Copy B: you complete all sections of the form (including fields to be completed by the doctor).

   • Pretend you are the doctor completing the form and write, to the best of your ability, all the details you would like to see included.

   • Your doctor will use your completed draft (copy B) to guide the completion of the final version of the form (copy A).

   • However, the final version will be completely at your doctor’s discretion.  If there is information in copy B that was previously not in your chart, an investigation to verify/prove the information will need to be done.

   • Write at the top of each page of copy B “Patient’s Answers”.

   • If you don’t have answers to some of the sections just write “I don’t know”.

   • You should skip any sections that require a doctor's examination findings or lab tests.  (e.g. For Ontario Driver's Medicals, just complete the front page as the back page is all about what the doctor found when you were examined.)
      

Why does the doctor require me to provide two versions of the form?

• It gives you the chance to provide the doctor with your complete perspective.

• It can help ensure accurate and detailed information.

• It will allow the doctor to complete the forms faster for your convenience.

 

We will not accept forms without the submission of both copies completed.  Please note that both copies of the form will be placed in your medical chart.

 

Please allow up to 30 days for the completion of the forms after we accept the forms.  The doctor is required to obtain and review all relevant information before completing the final draft of the form.  This includes requesting an appointment to examine you, ordering tests, waiting for reports, or requesting a specialist opinion - any of which may delay the form past 30 days.

 

The doctors are required to provide a full opinion substantiated by documented fact and evidence, without leaving out any relevant information.  Any attempt to falsify, coerce or manipulate the information that will go on the final draft of the form can result in dismissal from the practice.

 

At any point, as information becomes available, the doctor may request that you have another more appropriate provider fill out the form (e.g. physiotherapist, neurologist, etc.). If this situation occurs, no fee will be charged by the original doctor.