• Uninsured Visit — $100
• Uninsured follow-up visit — $75
• Uninsured Phone Visit — $ 50
• Missed Appointment — $50
• Uninsured Injection Fees — $20
• Sick Note — $20
• Return to Work Form — $40–$80
• MPI Driver’s Medical — $100
• Disability Tax Credit Form — $100
• Insurance Forms — $100–$150
• Functional Ability Form — $40
• Parking Permit Form — $30
• Chart Transfer — $40
• Above 30 pages — $0.30 per page
• Tuberculin Skin Test (TST)
  — $150 (per shot)
• Attending Physician
  Statement — $85
• School/Work Immunization
  Form — $40
• MPI Alcohol or Drug Reporting
  Forms — $40