As you may know, not all services performed by your family doctor are paid for by Alberta Health Care. Some services, called Uninsured Services, are performed by your family doctor but they are not paid by Alberta Health Care. These services need to be paid by you after you receive the service. Some examples of Uninsured Services are sick notes, parking forms etc.

Our clinic offers 2 ways to pay for some of these services. You can choose to pay for each uninsured service each time you require one or you can choose to buy a Package (Individual or Family).

The list is not exhaustive and may not include some services that you may require from time to time. If there are services that you require that are not included in this list then you will need to speak to clinic personnel in regards to the charge for the service and your Package will not include the cost of the uninsured service that is not listed above. If you buy the Individual Package then your fee ($125.00) automatically pays for the service included in the above list. If you choose a Family Package ($200.00) each family member will obtain the individual package of services listed above.

If you would like to sign up please complete the following form and send it to the Clinic. Or simply complete the form and bring it to the office. If you sign up in person then the receptionist can take your debit card/VISA/Mastercard for payment.

* Uninsured Services Package Form *