Medical forms to be filled out by a physician are not covered under provincial health care (Alberta or Saskatchewan)

Single Page/ Signature Only

2-3 Pages

4+ Pages

Doctor Note

Copy of results

Transfer of File (within Lloydminster)

(We only accept Cash)

$25 CAD

$50 CAD

$100 CAD

$25 CAD

$10 CAD

$50-100 CAD

Patient Forms

Lloyd Women's Clinic




1812 50th Ave, Unit 7

Lloydminster, AB  T9V2W7

Tel: 780-875-8755

Fax: 780-875-5868

©2020 Lloyd Women's Clinic | All Rights Reserved