Fee Schedule

  • Copy of Immunization record Free
  • Yellow immunization card Free
  • Each replacement card if lost $10
  • Excuse for School/work requested during a visit Free
  • If not requested during a visit $10
  • School/Sport/Camp/Health Form presented during a visit (limit 1 per visit) Free
  • If not requested during a physical exam $10
  • Copy of medical records $25 unless it is a thick chart
  • Letter $25 and up (to be decided by dr )
  • Retrieval of records from storage $50
  • If returning to our practice Free
  • Billing fee for co-pay not paid at time of service $10
  • Returned check fee $25
  • Special vaccine order handling fee $50
  • Surcharge for non-standard immunization schedule $50
  • Review of medical records for adoption $100-$500 (to be decided by dr )