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It's not on the checklist for the spousal application. It is a mandatory document for the spousal OWP application.

That's only if you're also applying for an OWP at the same time.

OWP approved today, application received November 29.

https://www.canada.ca/en/immigration-refugees-citizenship/corporate/publications-manuals/operational-bulletins-manuals/standard-requirements/medical-requirements/exam/medical-exemptions.html Exemptions from inadmissibility on grounds of excessive demand As per paragraphs R24, R117(g)and...

This is an inland application, it wouldn't be processed in Sydney.

That's not the same as the OWP application that's submitted with an inland spousal PR application. The wait time for the spousal OWP is 4-5 months: http://www.cic.gc.ca/english/helpcentre/answer.asp?qnum=1163&top=17

It's way too early in the process for sponsor approval.

http://www.cic.gc.ca/english/helpcentre/answer.asp?qnum=1306&top=17 "If you are applying for an open work permit, you usually have to pay the open work permit holder fee and the work permit processing fee at the same time."

Work permit and open work permit holder fee. So 155 + 100 = $255

Really?? From what I've seen on this forum and the Facebook group nobody has received AOR past Nov 23rd... (Mine was received Nov 29 and nothing yet)

Have they met on Skype or something similar? You can put that date and add a letter explaining the circumstances.

Applying for the OWP as a spousal PR applicant is not the same as SOWP. If you look on the website proof of funds is listed as a requirement for the SOWP but is not listed as part of the application package here...

Sponsor or principal applicant?

You need proof that you have lived together consecutively for 12 months.