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The IMM 1017 form, known as the Medical Report form for immigration applicants, plays a crucial role in the immigration process to Canada. When individuals apply for permanent residency or temporary residence, their health status is examined through this form. This document ensures that applicants meet the health requirements set by Immigration, Refugees and Citizenship Canada (IRCC). It consists of multiple sections that need to be filled out by both the applicant and a designated medical practitioner. The applicant must provide essential personal information, such as their name, date of birth, and relationship to their sponsor. Additionally, a recent photograph is required. The physician's section is equally important; it assesses the applicant's medical history and physical examination results. Various health conditions are documented, ranging from minor issues to more serious health concerns, impacting the overall assessment of the applicant’s ability to live independently in Canada. By clearly outlining medical findings and declaring the applicant's identity, the IMM 1017 form helps the Canadian immigration authorities make informed decisions. Completing this form accurately and thoroughly is essential for a smooth immigration process.
Imm 1017 Example
■ jb ■ Citizenship and |
Citoyennete et |
■■ Immigration Canada Immigration Canada
Medical Report: Section A - EDE
SPOUSE OR
SECTION 1 * You must complete this section. Print clearly, in block letters.
Client Identification & Summary
Surname: |
(provide alias in brackets) |
Forename/First Names |
|
Sex |
Dale of Birth |
Country of Birth |
Intended Canadian Destination |
|
Day I Month |
Year |
|
Mailing Address (If further medical information is required) |
Relation to Sponsor |
||
Spouse or
Dependent Child
Contact Address/Person within Canada (name, full address and telephone number)
PROTECTED WHEN COMPLETED - В
Г“I
l__l
PHOTO
Required for all applicants.
Must be taken within six months
of the medical examination.
SECTION 2 - To be completed by a Designated Medical Practitioner
PHYSICIAN'S SUMMARY AND DECLARATION BASED ON HISTORY AND PHYSICAL EXAMINATION
✓check off ALL appropriate item(s):
A. Findings that are unremarkable or minor conditions which normally respond well to short term outpatient treatment. Immediate surgery is
not required. Applicant can be followed by a general practitioner and will have minimal requirements for hospitalization or social services. No active ТВ or dangerous behaviour, (e.g. controlled diabetes and/or hypertension with no associated significant end organ damage, cataracts not requiring immediate surgery, psychiatric disorders that are well controlled and where the applicant is capable of working and will likely remain
□B. Findings that require periodic specialist
or the provision of social services (e.g. totally asymptomatic congenital or rheumatic heart disease where the requirement for hospitalization and/or surgical
intervention appears very unlikely over the next
function independently and be
developmental delay. No active ТВ or dangerous behaviour. At most, only minor hospitalization likely in the near future.
c. Findings that may require more extensive investigation or care. Applicants where:
(1)HOME/INSTITUTIONAL SUPERVISION & CARE IS NEEDED.
(2)MAJOR HOSPITALIZATION (especially for procedures involving any joint replacements, transplantation, cardiac surgery, subspecialist care, repeated hospitalization) is required.
(3)SPECIALIZED HOSPITAL FACILITIES such as DIALYSIS units or CANCER outpatient clinics is needed.
(4)There is the need for use of intermittent/continuing SOCIAL SERVICES, or specialized educational/vocational training.
(5)DETERIORATION appears quite likely.
(6)the normal acquisition or maintenance of
(7)ACTIVE ТВ appears to be present (or an easily communicable serious infectious disease).
(8)BEHAVIOUR appears to be POTENTIALLY DANGEROUS to others (e.g. some psychiatric disorders or illicit drug/alcohol abuse during the
especially when associated with impaired driving or legal difficulties).
EXAMPLES: dementia; mental retardation; developmental delay requiring special educational/training, renal insufficiency; diabetic nephrr |
;ychiatric |
disorders causing clinically significant distress or impairment in social, occupational, or other important areas of functioning; symptomatic heart disease of any cause; dialysis;
conditions with the potential of deterioration; genetic/inherited disorders likely to create a functional deficit.
D. Other conditions/disorders difficult to categorize or where there is a lack of medical information.
DECLARATION: I declare that I have confirmed the identity and examined this applicant and that this is a true and correct record of my findings.
Physician’s full name, address and telephone number (OFFICE STAMP MAY BE USED)
E
Date
Day Month Year
I I I I I
Place of examination
IMM 1017 SCL |
(DISPONIBLE EN FRANQAIS - IMM 1017 SCL F) |
Canada
File Breakdown
| Fact Name | Description |
|---|---|
| Purpose | The IMM 1017 form is a medical report required for individuals applying for immigration to Canada, specifically for health assessments. |
| Completion Requirement | All applicants must complete Section 1, which includes personal identification and details of their intended Canadian destination. |
| Medical Practitioner Role | A designated medical practitioner must complete Section 2 with a summary and declaration of the applicant's medical status based on examination. |
| Photo Requirement | All applicants must provide a recent photo taken within six months of their medical examination. |
| Governing Law | The form operates under Canadian immigration laws, ensuring that health assessments align with immigration criteria outlined by Immigration, Refugees and Citizenship Canada (IRCC). |
Guide to Using Imm 1017
Completing the IMM 1017 form involves providing important personal details and medical information. This form is typically required for individuals who are applying for immigration to Canada and need to undergo a medical examination. Follow the steps below carefully to ensure all required information is filled out properly.
- Start with **Section A**. Print your surname clearly. If you have an alias, include it in brackets.
- Fill in your first names and other personal details as requested, including your sex, date of birth, and country of birth.
- Indicate your intended destination in Canada and your relationship to the sponsor. Select either "Spouse or Common-Law Partner" or "Dependent Child".
- Provide your mailing address and a contact address or person in Canada, including their full address and telephone number.
- Attach a recent photo of yourself taken within six months of your medical examination, as required for all applicants.
- Move to **Section 2**, which needs to be completed by a Designated Medical Practitioner. This section is crucial, as it contains your medical summary and declaration.
- The physician will check the appropriate boxes based on their findings about your health. Ensure all relevant information is included.
- Finally, the medical practitioner must sign and date the form. Their full name, address, and telephone number should also be included. An office stamp may be used for verification.
Get Answers on Imm 1017
What is the purpose of the IMM 1017 form?
The IMM 1017 form, also known as the Medical Report, is required by Citizenship and Immigration Canada to assess the medical conditions of individuals applying for immigration. It plays a crucial role in determining whether an applicant poses a health risk to the Canadian public or if they might require excessive health or social services once settled in Canada. By completing this form, prospective immigrants undergo a medical examination, which includes both a patient's health history and a physical examination performed by a designated medical practitioner.
Who needs to complete the IMM 1017 form?
The IMM 1017 form must be filled out by all individuals applying for immigration to Canada who require a medical exam. This includes sponsors, spouses or common-law partners, and dependent children. Each applicant regarded as part of the immigration process must undergo a medical examination and have a separate form completed to reflect their personal health information accurately.
What information is required in Section 1 of the form?
Section 1 of the IMM 1017 form collects essential identification details about the applicant. You must provide information including:
- Surname and any aliases
- Sex
- Date of Birth
- Country of Birth
- Forename/First Names
- Intended Canadian Destination
- Relation to Sponsor (e.g., Spouse, Common-Law Partner, Dependent Child)
- Mailing Address
- Contact information for someone within Canada
- A recent passport-size photograph
This section must be completed in clear, block letters to ensure accurate processing of your application.
What should I expect during the medical examination?
During the medical examination, designated medical practitioners will assess your overall health. Expect the examination to include a review of your medical history and a physical examination. The physician will check for unremarkable conditions and any serious health issues. Various findings may be noted, such as whether you require outpatient treatment or if there’s a need for specialized care. The medical history is pivotal in helping immigration officials determine your medical conditions and needs appropriately.
How long is the IMM 1017 form valid for?
The IMM 1017 form is typically valid for a limited period after the medical examination. Generally, the results of the medical examination remain valid for 12 months from the date of completion. However, it is essential to check for specific guidelines or updates from Citizenship and Immigration Canada, as requirements may change. Promptly submitting your completed form before the expiration will ensure more streamlined processing of your immigration application.
What if there are findings that require further investigation?
If the designated medical practitioner identifies health conditions that warrant further investigation or care, they will indicate this on the form itself. Depending on the findings, follow-up examinations or referrals to specialists may be required. It is crucial to stay in touch with the medical practitioner for any follow-up appointments and to provide any additional information that may be requested to address these findings adequately.
Common mistakes
Completing the Imm 1017 form, which is required for medical examinations in the immigration process, demands careful attention to detail. Mistakes in this form can lead to delays in the application process or even denial. Here are six common errors that applicants often make.
One common mistake occurs in Section A, where applicants may omit necessary personal details. Providing clear and complete information such as surname, date of birth, and country of birth is crucial. For instance, failing to include an alias or nickname can result in confusion and further inquiries from immigration officials.
Another frequent error involves photograph requirements. The form specifies that a recent photo is required for all applicants. Some individuals neglect to ensure that their photo meets the specifications or is taken within the designated six-month period, which can lead to rejection of the application.
In Section 2, which is to be completed by a designated medical practitioner, applicants may overlook the necessity of having a qualified physician fill out the medical history and examination summary. Using a physician who is not authorized or failing to provide a detailed report can jeopardize the application.
Many applicants also mistakenly forget to provide a mailing address for further correspondence or the contact information of a person within Canada. This information is essential for any follow-up communication, and without it, applicants may miss important updates regarding their application.
Additionally, errors can occur in the section concerning the applicant's medical history. Misreporting or failing to declare significant health conditions can result in serious consequences. For instance, neglecting to disclose chronic diseases or previous surgeries may raise flags during the assessment process.
Finally, some individuals fail to sign or date the form, particularly the physician's declaration. This oversight can lead to automatic rejection since the form must demonstrate confirmation of identity and findings from the examination.
Awareness of these common mistakes can streamline the application process and minimize stress. Review each section carefully and seek assistance if needed to ensure all information is accurate and complete.
Documents used along the form
The IMM 1017 form is a critical document used in the immigration process, specifically for health examinations. It is often accompanied by several other forms and documents that help create a comprehensive application. Below, you will find descriptions of other documents that are commonly utilized alongside the IMM 1017 form, providing crucial information about an applicant's eligibility and health status.
- IMM 0008 (Generic Application Form for Canada): This form is used by individuals applying to immigrate to Canada. It collects vital personal details and information regarding the applicant’s background, helping the immigration authorities assess eligibility.
- IMM 5406 (Additional Family Information): This document is needed to provide details about the applicant’s family members. It ensures that all relevant relationships are documented, which can affect the outcome of the immigration application.
- IMM 5669 (Background/Declaration): The purpose of this form is to gather information about the applicant's personal history, including education and employment. It serves to verify the applicant's identity and assess any potential security risks.
- IMM 5476 (Use of a Representative): If an applicant decides to have someone represent them in their immigration process, this form is required. It grants permission for a representative to act on the applicant's behalf, ensuring all communications are handled appropriately.
- Schedule A (Background/Declaration): This specific document is necessary for applicants applying as permanent residents. It provides a thorough account of the applicant's past and assists in background checks conducted by immigration authorities.
- Police Clearance Certificates: Required for applicants over a certain age, these certificates confirm that a person has no criminal record in the countries where they have resided. They are essential in determining an applicant's suitability for immigration.
- Passport and Travel Documents: A copy of the applicant's passport is needed to verify identity and nationality. The travel documents serve as proof of legal status in the country of origin when applying for immigration.
- Medical Examination Results: Alongside the IMM 1017 form, the results from the medical exams conducted by designated practitioners must accompany the application. This documentation is crucial for determining the applicant’s medical admissibility to Canada.
- Photographs: Recent passport-sized photographs, taken within the past six months, are essential for identification purposes. These images must meet specific guidelines set by immigration authorities.
Understanding the various documents required alongside the IMM 1017 form can streamline the immigration process. By ensuring all necessary paperwork is completed and submitted, applicants can enhance their chances of a successful application, navigating this complex journey with greater confidence.
Similar forms
- Form I-693: This U.S. Citizenship and Immigration Services (USCIS) form is a medical examination report used in the immigration process. Like the Imm 1017, it assesses the applicant's health and identifies any medical issues that could affect their immigration eligibility.
- Form DS-2054: Used by the U.S. Department of State, this form is a medical examination for immigrants and refugees. Similar to the Imm 1017, it reviews medical history and current health status to determine if the applicant meets health-related immigration requirements.
- Form I-601: This is a waiver application for certain grounds of inadmissibility, including health issues. Both forms address health conditions that may lead to immigration complications.
- Form I-485: The application to register permanent residence or adjust status. This form requires medical information, aligning with the purpose of the Imm 1017 to ensure applicants do not pose health risks.
- Form I-864: This form serves as an affidavit of support, ensuring that immigrants will not become public charges, which can include consideration of health-related costs similar to those noted in the Imm 1017.
- Form G-325A: Used to collect biographic information as part of the immigration process, this form complements the Imm 1017 by gathering information relevant to an applicant's health history.
- Form N-400: The application for naturalization includes questions related to health and moral character, paralleling the health evaluation in the Imm 1017.
- EA-2848: This is a Power of Attorney form used when dealing with immigration issues. While not a health assessment, it may be used in conjunction with forms like the Imm 1017 in managing medical and legal communication.
- Form I-912: This fee waiver request form can be linked to medical issues if health concerns create financial difficulties. Both forms reflect aspects of affording health-related costs in the immigration context.
- Form N-565: Used to apply for a replacement certificate of citizenship, this form may require submitting medical information, similar to the medically relevant findings in the Imm 1017.
Dos and Don'ts
- Do: Complete all sections of the form accurately and truthfully.
- Do: Print clearly in block letters to ensure legibility.
- Do: Include all required photographs taken within the last six months.
- Do: Provide the correct mailing address for further communication.
- Don't: Leave any sections blank; all applicable fields must be filled out.
- Don't: Use abbreviations or informal language when filling out the form.
- Don't: Submit outdated photographs or documents.
- Don't: Provide false information, as this can lead to serious repercussions.
Misconceptions
Understanding the Imm 1017 form is essential for anyone navigating the immigration process in Canada. Unfortunately, there are several misconceptions surrounding this form that can lead to confusion. Here is a list of six common misconceptions:
- All applicants must have a clean bill of health. Many believe that only those in perfect health can apply. However, the Imm 1017 form allows for medical conditions as long as they are controlled and do not require extensive care.
- The form is only required for certain visa categories. Some people think that only applicants for permanent residency need to fill out the Imm 1017. In reality, any individual undergoing a medical examination as part of their immigration process may need this form, regardless of their visa type.
- Submission delays are always due to medical issues. While health concerns can delay processing, there can be numerous reasons for delays, including missing documentation or incomplete applications. It is important to keep lines of communication open with immigration authorities.
- Medical practitioners must be specialists. A misconception exists that only specific types of doctors can fill out the Imm 1017 form. In fact, a designated medical practitioner can be a general practitioner, as long as they meet the required criteria set by immigration authorities.
- The form is only about physical health. The Imm 1017 assesses both physical and mental health. Certain psychiatric conditions must be reported as well, particularly if they might affect an applicant's ability to integrate into society.
- Once submitted, the medical findings are permanent. Another misunderstanding is that medical evaluations are fixed and cannot change. Should an applicant’s health status improve or worsen, they can provide updated medical information to immigration authorities.
Addressing these misconceptions can lead to a smoother immigration process. Understanding each aspect of the Imm 1017 form is crucial for proper compliance and to ease any worries about health-related immigration matters.
Key takeaways
Ensure you complete Section 1 of the Imm 1017 form accurately. Use block letters for clarity.
Include your full surname, date of birth, country of birth, and other required identification information.
Attach a recent photo of yourself taken within the last six months.
Consult with a Designated Medical Practitioner for Section 2. They must provide a summary and declaration based on your medical history and examination.
Your medical practitioner should check off all relevant items regarding your health conditions or findings.
Please note that some findings may indicate a need for specialist follow-up care or hospitalization.
Indicate any need for ongoing social services or specialized educational/vocational training clearly.
Be aware that any evidence of active tuberculosis or potentially dangerous behavior must be disclosed.
Make sure to have your physician declare and sign the form, confirming the accuracy of the information provided.
Keep a copy of the completed Imm 1017 form for your records and future reference.