Patient Resources

Please check here regularly for helpful forms, documents, resources, and links.

I have a form or document to share. Where do I send it?
Please email your documents to upload to

Please include:

  • Your name as appears on your BC Services Card; and
  • DOB (Date of Birth): or
  • Your Personal Health Number (PHN)

Any missing information may delay your documents being uploaded into your medical chart.


FOR DOCUMENTS: Please make sure you send legible documents in PDF format. Photos may not be considered a legal copy of your document and may not be uploaded into your medical chart. Please use an app like Adobe Scan (Android/iOS) to create pdf documents.

I have a form to be filled by my family doctor. What do I need to do?
Please ensure sufficient time has been given to your family doctor to fill out forms. Book a separate appointment and notify any requirements of your form.


Please also be aware that form filling, generally, is not a covered benefit of MSP and may incur a private fee. This fee is the responsibility of the patient unless indicated otherwise.

What is covered by MSP?
Even if a BC resident is insured under the Medical Services Plan (MSP) and/or other affiliated medical plans (i.e. Blue Cross, Sun Life, etc.), not all services provided by a doctor are covered. These services are considered not medically required and are billed directly to the patient. Patients are encouraged to speak with their doctor regarding the fee(s) for the non-MSP-insured service requested and if needed, to work out a payment plan. Doctors of BC has established recommended fees for some non-MSP-insured (not covered) services to help guide doctors in setting a reasonable value for these services.

For more information, please visit:

What are your fees for non-insured individuals or for services not covered by MSP?
Imperial Medical Clinic follows the recommended reasonable fee schedule set by the Doctors of BC (formally known as The BC Medical Association). Please see the 2022 fee guide for more detailed information.

For more information on Doctors of BC recommended fees for uninsured services, please contact our clinic or Doctors of BC – Lea Harth at 604-638-2827 or

2022 Doctors of BC Uninsured Fees


Uninsured Fee Schedule

Some services are not a covered benefit of MSP. For services not covered, IMC charges fees suggested by the Doctors of BC. (some conditions may apply)

Request of Medical Records Form

Use this form if you would like to request a copy of your medical chart/records from your previous clinic to your new Family Doctor at IMC. Please note, there is a private fee for this service.

New Patient Intake Form

If you have been rostered to your new Family Doctor at IMC, please fill out this form.

New Patient Consent Form

If you have been rostered to your new Family Doctor at IMC, please fill out this form.

Consent to Procedure

If you are scheduled for a surgical/procedure, please fill this form.

Motor Vehicle Accident (MVA) Questionnaire

Use this form if you are scheduled for an initial consultation for motor vehicle accident (MVA) with Dr. Pavan Kaliray

OAT  Program Intake Form

If you have been rostered to the Opioid Agonist Treatment (OAT) Program with Dr. Jag Kaliray, please fill out this form.

Useful Information for Patients

Useful Information for New Parents

New and expecting parents, please read this for useful information.

Infant and Children Acetaminophen and Ibuprofen Shortage

A guide for parents on recent acetaminophen and ibuprofen shortage for children.

2022-2023 Doctors of BC Uninsured Services Fees

A fee guide of services that are not covered by MSP and/or for uninsured individuals.