Policies

Policies:

Privacy Statement

The physicians and staff at Waterloo West Medical are bound by law and ethics to safeguard the privacy and confidentiality of your personal information.

We collect, use and disclose your personal health information to:

  • Treat and care for you

  • Get payment for your treatment and care (from OHIP, WSIB, your private insurer or others)

  • Plan, administer and manage our internal operations;

  • Conduct risk management and quality improvement activities

  • Teach

  • Conduct research

  • Compile statistics

  • Comply with legal and regulatory requirements

  • Fulfill other purposes permitted or required by law

Your request for care implies consent for our collection, use and disclosure of your personal information for purposes related to your care as noted above.  All other purposes would require your expressed consent.

We may share your health information with other healthcare providers to continue to care for you.  This includes healthcare providers at other organizations who can view your information to care for you.

You have the right at any time to withhold or withdraw your consent to disclose personal health information.  You will be required to sign the appropriate form, which will be forwarded to the Privacy Officer.

Zero Tolerance Policy

Our office is committed to providing a safe, secure and respectful environment for all patients and staff.

Words or actions that make others feel threatened or demeaned will not be tolerated and decisive action will be taken to protect patients and staff.

Disruptive Behaviour

We consider the use of inappropriate words, actions or inactions as disruptive behaviour.

Inappropriate Actions/Inactions:

  • Violence (physical attacks or threats of harm)

  • Intimidation

  • Throwing, damaging property or breaking things

  • Unwelcomed physical contact

  • Failure to observe office policies and/or contracts

  • Refusing to leave the property

Inappropriate Words (in person, by phone or any means of communication):

  • Abusive language and yelling

  • Disrespectful or demeaning language/comments

  • Remarks, jokes or innuendos that degrade, ridicule or offend

  • Discriminatory remarks

  • Threats or threatening behaviour

  • Bullying

  • Sexual harassment

Immediate action will be taken when the incidents described above occur.

Individual(s) may be asked to leave, the police may be called or the individual (s) may face dismissal from our practice

Missed Appointment and Late Arrival Policy

Our office requires 24 hours notice to cancel an appointment

Arrive 10 minutes early

Late arrivals may be considered Missed Appointments

Missed Appointment Fee will need to be paid before booking future appointments

The fee schedule posted in the office per Ontario Medical Association Uninsured Services

Guide

  • If you miss more than 3 appointments, you may be restricted to same-day appointments only or will be dismissed from the practice

• We make every effort to run on time, however, there are situations outside of our control that may disrupt the schedule

Fees for Uninsured Services (Updated 2023)

Missed appointment without prior notice $40-90

Off work/school note $25

Orthotics / Physio / Massage Therapy $25

Non-OHIP insured immunizations $25

Liquid Nitrogen Treatment $50+

Minor procedures (non-insured) $150-300

Driver’s Physical and Form completion $175

Documentation/forms for school / pre-employment $45

Disability / Insurance Forms $ varies (starts $60/pg)

Attending Physician Statement $160

CRA Disability Tax Credit Form $150

Travel cancellation insurance Form $45

Medical Certificate for EI compassion care $62

Life Insurance Death Certificate $54

Reproduction / Transfer of Medical Records $35 (first 20 pages)
+ $0.25 / page thereafter
+ Physician Review fee
+ USB and courier fee when applicable

Form completion fee subject to change depending on complexity of the form You will be advised of the fee prior to form completion

Fees are based on the Ontario Medical Association Guide to Uninsured Services