PRICE LIST PRICE LIST FOR SERVICES NOT COVERED BY HEALTH INSURANCE SERVICE PRICE 1. Completion of the accident insurance form 200 Kč 2. Assessment of eligibility for admission to preschool or daycare 200 Kč 3. Assessment of eligibility for enrollment in university, high school, or vocational school (for each application, for various fields of study) 200 Kč 4. Assessment of medical fitness to operate motor vehicles 300 Kč 5. Examinations for employment agencies and courts (upon request) 300 Kč 6. Medical examinations for long-term stays abroad 300 Kč 7. Medical fitness assessment for participation in summer camps, winter camps, and sporting events 200 Kč 8. Ear piercing (2 earrings) 600 Kč 9. Administration of injections 300 Kč 10. Health card 200 Kč 11. Extract from medical records (upon request) 300 Kč 12. Issuance of a replacement document 200 Kč 13. Certificates for various purposes 200 Kč 14. Blood draw and blood type testing (upon request) 300 Kč 15. Assessment of the health status of hospitalized patients at the request of a legal representative 200 Kč 16. Telephone consultation (outside office hours on the doctor’s private line) 15 min./150 Kč 17. Completion of foreign-language questionnaires 500 Kč 18. Consultation services unrelated to the patient’s health condition 60 min./500 Kč 19. Examination of a child separately, outside office hours, by appointment 15 min./300 Kč