INFORMATION FOR PHYSICIANS AND RADIOGRAPHERS
1. Instructions for Canadian Immigration Medical Examinations
The attached Medical Report form, IMM 1017 (see bottom of form), is the first page of a seven-page document. The first page is titled "Section A, Client Identification & Summary." There are six additional pages which contain Sections B through E of the Medical Report form. The six additional pages, also known as form IMM 5419, are sent in CD ROM format directly to Panel Physicians by the Director of Immigration Health Programmes (address below) for Citizenship and Immigration Canada.
Generally, applicants for immigration are only given Section A of the Medical Report form and do not receive Sections B to E. You should have copies of the form IMM 5419, which contains Sections B to E. If you do not, please write to the Director of Immigration Health Programmes, at the address below, for information on how to obtain the form IMM 5419 on CD ROM.
2. Procedures for medical examination:
(a) The person presenting this form requires the following medical tests:
- complete medical examination - for persons of all ages
- chest x-ray and report - for persons 11 years of age and over
- urinalysis - for persons 5 years of age and over
- syphilis serology - for persons 15 years of age and over
- HIV testing should be performed on all applicants who are 15 years of age and over, as well as on those children who have received blood or blood products, have a known HIV positive mother, or are potential adoptees
(b) The results of the examination must be reported on form IMM1017 AND form IMM 5419.
Form IMM 1017 + Form IMM 5419 = one Medical Report
One complete Medical Report is required for each person examined.
(c) Actual laboratory reports are required.
3. Procedures for x-ray:
(a) The radiographer will assure himself as to the identity of the person to be x-rayed and will inscribe, over his or her signature, the name of the person, the date of the x-ray and passport number, if available, at the center bottom of the film. Care MUST be taken to ensure that the picture of the lung tissue is not obscured.
3.
(b)
In his or her report, the doctor reading the chest x-ray will describe all abnormalities in the x-ray film. The report is to be signed by the doctor who will also indicate his or her office address and identify the report as relating to the film and the person concerned.
(c) Large x-ray films are required, corresponding to the standard sizes of diagnostic films (35 x 43 cm).
(d) The following are NOT acceptable:
- a photograph of an x-ray
- a report based on fluoroscopic examination only
- an x-ray film that is technically unsatisfactory
- a film which does not demonstrate the entire chest
- a film more than one month old at time it is received by Immigration
Health Programmes in Ottawa
- a report without the film upon which the report is based
- a positive film or print
4. Packing and mailing the medical information:
a) The x-ray film and report, laboratory and medical reports are to be suitably packaged (not rolled) to avoid damage in transit. It is mandatory that the examining physician send all documents and chest x-ray(s) directly to the following address:
Director, Health Programs (RNH), Citizenship and Immigration Canada Canadian Building, 219 Laurier Avenue West, 3rd Floor Ottawa, Ontario KIA ILl Canada
Note: Under no circumstances should any document or chest x-ray be given to the applicant!
b) The contents of the parcel are to be identified with the applicant's complete postal address, the address of the Immigration Visa Office dealing with the application (found at the bottom of this page), and the file number (see box labelled "Visa Office & Number" in the upper right corner of form IMM 1017). The chest x-ray film and reports become the property of the Department of Citizenship and Immigration Canada and are NOT returnable. medical\inst_dr/Nov 05