<div class="ap-service-section3">
<div class="container">
<h4>Uninsured services COVERED by the Basic Plan</h4>
<h4>FORMS</h4>
<table>
<tr>
<th>Service</th>
<th>Price</th>
<th>Checkout</th>
</tr>
<tr>
<td>Prescription Renewals by phone/fax/online (when appropriate and only at the request of the patient)</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/jcyix3x-fsaklx4mknuolr/Prescription-Renewals-by-phonefaxonline-when-appropriate-and-only-at-the-request-of-the-patient'">
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</tr>
<tr>
<td>Transfer of Medical Records (each page after 5 will be $1.50)</td>
<td>First 1-5 pages $35.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/5fpel6w-ki942s6o4yhzwa/Transfer-of-Medical-Records-each-page-after-5-will-be-150'">
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</tr>
<tr>
<td>Letters on behalf of patients (depending on time and work involved)</td>
<td>$25 - $200</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/xtj2buh-u4rpydo7pk18vd/Letters-on-behalf-of-patients-depending-on-time-and-work-involved'">
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</tr>
<tr>
<td>Travel Advice in the office (2 people or more, $60)</td>
<td>For 1 person $30.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/qw1gmj3-fsaklx4mknu2nr/Travel-Advice-in-the-office-2-people-or-more-60'">
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</tr>
<tr>
<td>Lost Prescriptions, Notes, Referrals</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/f0d9ghn-1mtia84yixc3ax/Lost-Prescriptions-Notes-Referrals'">
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</tr>
<tr>
<td>Uninsured Vaccine Administration</td>
<td>$15.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/zgbuqwf-xhdg7aqkgjpnti/Uninsured-Vaccine-Administration'">
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</tr>
<tr>
<td>TB Test</td>
<td>$40.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/pwu6kj7-39njz1rcj7po9m/TB-Test'">
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</tr>
<tr>
<td>TB Test Reading</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/9lqefng-g8wqi6lrq2abfy/TB-Test-Reading'">
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</tr>
<tr>
<td>Medical Examination for Return to Work requested by Employer</td>
<td>$75.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/3eq1nyk-x7a9bjed9g0kxn/Medical-Examination-for-Return-to-Work-requested-by-Employer'">
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</tr>
<tr>
<td>Third Party Physical Exam</td>
<td>$100.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/bpcj7ym-32qabf74amon58/Third-Party-Physical-Exam'">
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</tr>
<tr>
<td>Photocopying</td>
<td>$1.00 per page</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/9aj8h2v-2tw4soup437lbq/Photocopying'">
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</tr>
<tr>
<td>Medical Supplies, Dressings, etc.</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/7pcy2fz-39njz1rcj7p4nm/Medical-Supplies-Dressings-etc'">
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</tr>
</table>
<h4>INSURANCE REPORTS</h4>
<table>
<tr>
<th>Service</th>
<th>Price</th>
<th>Checkout</th>
</tr>
<tr>
<td>Citizenship and Immigration Report</td>
<td>$40.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/0o4am98-t1qjgbfkja2i6u/Citizenship-and-Immigration-Report'">
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</tr>
<tr>
<td>Commercial weight loss program</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/yumkn6r-sxaz8hopzwrhvs/Commercial-weight-loss-program'">
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</tr>
<tr>
<td>Illness and Return to Work Notes</td>
<td>$35.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/809k6n4-t9r23b572ljbbe/Illness-and-Return-to-Work-Notes'">
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</tr>
<tr>
<td>Employment Insurance / Maternity Certificate</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/lrhowi2-y0g2cwv82xkjlb/Employment-Insurance--Maternity-Certificate'">
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</tr>
<tr>
<td>Fitness Club Forms</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/sje0hyt-o7329dhj2bt6qh/Fitness-Club-Forms'">
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</tr>
<tr>
<td>Private Insurance Forms</td>
<td>$30 - $200</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/vrpzwys-ujx12a9q1ne4qk/Private-Insurance-Forms'">
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</tr>
<tr>
<td>Pre-employment Certificate of Fitness</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/zgbuqwf-2i4uno5buqgswf/Preemployment-Certificate-of-Fitness'">
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</tr>
<tr>
<td>Jury Duty Letter</td>
<td>$15.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/5fpel6w-o7329dhj2bte2h/Jury-Duty-Letter'">
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</tr>
<tr>
<td>Certificate of Medical Status</td>
<td>$25 - $35</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/bpcj7ym-o7329dhj2bteih/Certificate-of-Medical-Status'">
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</tr>
<tr>
<td>Massage Therapy and Orthotics</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/0o4am98-o7329dhj2btrth/Massage-Therapy-and-Orthotics'">
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</tr>
<tr>
<td>Revenue Canada Disability Form</td>
<td>$75.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/n2kjacu-32qabf74amoiv8/Revenue-Canada-Disability-Form'">
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</tr>
<tr>
<td>Day Care Notes</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/5r3m7dj-daw9fvik91fii6/Day-Care-Notes'">
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</tr>
<tr>
<td>School / Camp Forms</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/qho4yna-1s3yuxbcy2ubgz/School--Camp-Forms'">
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</tr>
<tr>
<td>Travel Cancellation Forms</td>
<td>$25.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/0o4am98-7w50k9ue0hkcqt/Travel-Cancellation-Forms'">
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</tr>
<tr>
<td>Auto Accident Insurance Forms (when not covered by insurance)</td>
<td>$108</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/3eq1nyk-dzpe6sjqef6jhg/Auto-Accident-Insurance-Forms-when-not-covered-by-insurance'">
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</tr>
<tr>
<td>Disability Tax Credit Certificate</td>
<td>$50.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/5fpel6w-xhdg7aqkgj7x0i/Disability-Tax-Credit-Certificate'">
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</tr>
<tr>
<td>Referral Note for Chiropractor, Physiotherapy, etc.</td>
<td>$20.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/3eq1nyk-fsaklx4mknlfrr/Referral-Note-for-Chiropractor-Physiotherapy-etc'">
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</tr>
<tr>
<td>Children's Aid Society Forms</td>
<td>$45.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/3bk91u6-daw9fvik91fsx6/Childrens-Aid-Society-Forms'">
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</tr>
<tr>
<td>Replacement of Immunization Certificate</td>
<td>$15.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/fbtn8do-1mtia84yixad2x/Replacement-of-Immunization-Certificate'">
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</tr>
<tr>
<td>Forms required for Volunteer Work</td>
<td>$35.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/yumkn6r-sxaz8hopzw8xfs/Forms-required-for-Volunteer-Work'">
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</tr>
</table>
<h4>The following uninsured services are NOT COVERED by the Basic Plan</h4>
<p>Available as per standard guidelines set by the Saskatchewan Medical Association - SMA</p>
<table>
<tr>
<th>Service</th>
<th>Price</th>
<th>Checkout</th>
</tr>
<tr>
<td>Missed appointment</td>
<td>$30.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/dj72lfe-1s3yuxbcy2uszz/Missed-appointment'">
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</tr>
<tr>
<td>Missed Annual Physical Examination</td>
<td>$60.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/fbtn8do-fsaklx4mknludr/Missed-Annual-Physical-Examination'">
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</tr>
<tr>
<td>Driver's Medical Form (MOT) (non-subscriber, $150.00)</td>
<td>Basic plan subscriber $75.00</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/pwu6kj7-xhdg7aqkgj7pli/Drivers-Medical-Form-MOT-nonsubscriber-15000'">
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</tr>
<tr>
<td>Insurance/Disability Forms</td>
<td>SMA rate</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/zgbuqwf-qgmft16lf9tti1/InsuranceDisability-Forms'">
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</tr>
<tr>
<td>Legal reports</td>
<td>SMA rate</td>
<td><button style="background-color: #4CAF50; color: white; border: 2px solid #4CAF50; border-radius: 5px; padding: 8px 16px; font-size: 14px; cursor: pointer;" onclick="window.location.href='https://zohosecurepay.com/checkout/m5dnpqc-2i4uno5buqnnqf/Legal-reports'">
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</tr>
</table>
</div>
</div>