All personal and health information is kept confidential and secure in accordance with applicable laws. MedCare Diagnostics operates under a shared care model. MedCare Diagnostics will not disclose any personal or health information to any third party (without express prior consent) except to those individuals necessary for the provision of medical services in accordance with applicable law. For all medical/physician services, a valid OHIP card must be presented at each visit to receive medical care. In the event an expired or invalid OHIP card is presented, patients will be billed directly for the medical appointment before the appointment. This payment is non-refundable. For all medical services not covered by OHIP, payment is required at the time of service. Some payments are non-refundable and may be subject to a processing fee. MedCare Diagnostics provides all patients with the required receipts and documents for submission to insurance companies or any 3rd party coverage providers. Please note that each patient's insurance agreement is an agreement between themselves and the insurance company directly. In the event that any insurance company or 3rd party coverage provider does not completely reimburse or reject any claim provided at MedCare Diagnostics, the patient remains responsible for all fees. Please note that certain healthcare providers at our facility exclusively see adult patients (18 years of age and older). We recommend verifying provider eligibility for younger patients prior to booking an appointment. Not all services are available and are subject to Provider availability. Please check with your local MedCare Diagnostics for further information. To ensure you receive the care you need, we recommend contacting your local MedCare Diagnostics directly. The clinic staff can provide you with up-to-date information about the services available at your specific location, as well as the availability of healthcare providers. I acknowledge that I have read and fully understand this form, disclaimers, terms of use, patient responsibilities and policies listed on the MedCare Diagnostics website. I consent to the conditions outlined herein, as well as any other instructions that the healthcare providers may impose to communicate with me as well as all of MedCare Diagnostics policies, terms and conditions.
Intravenous (IV) iron infusions are administered in accordance with the product monograph administration guidelines. IV iron prescriptions, Monoferric® and Ferinject®, are dispensed through the on-site pharmacy. These medications are billed through the patient’s prescription drug insurance coverage where applicable, or directly to the patient. Medication costs are separate from clinic service fees, and patients are responsible for any portion not covered by their insurance plan. A separate fee applies for IV iron administration and monitoring. This fee is not included in the medication cost and will be charged independently. Patients must have completed relevant blood work within the past three (3) months and provide an up-to-date list of current medications prior to receiving treatment. By submitting this form, the patient authorizes the referring provider to order additional laboratory investigations, including iron studies, if clinically indicated. By submitting this form, both the patient and referring provider consent to being contacted by MedCare Diagnostics via email, fax, text message, or telephone for the purposes of appointment scheduling and coordination of care. Appointment details will be communicated directly to the patient. MedCare Diagnostics operates as a medical facility and office space provider. All medical consultations, assessments, prescribing, and infusion services are provided independently by licensed healthcare professionals. IV iron infusion services provided at this facility do not negatively impact patient enrollment or services within a Family Health Organization (FHO) model. Same-week appointments may be available. Some services may not be insured by OHIP and may require payment by the patient or coverage through private insurance plans or a Health Spending Account (HSA).