You don't need to send it to CIC, however, I ended up sending mine via registered mail anyway.
I attach this "information sheet" with my document updates to CIC (had to earlier attach an updated option C [CRA f&cked up my husband's tax calculation earlier and sent another form]) and this time used for my medical. I will use it again next week to send copies of my new passport:
PLEASE FIND THE PROOF OF e-MEDICAL ATTACHED WITH THIS INFORMATION SHEET REGARDING THE SPOUSAL SPONSORSHIP AND PR APPLICATION OF
xxxx AND xxxxx
PRINCIPAL APPLICANT
Surname - Exactly as it appears on the passport or identity document: xx
Given name(s) - Exactly as it appears on the passport or identity document: xx
Date of birth (YYYY-MM-DD): xxxx-xx-xx
Country of birth: xxx
(If available) Universal Client Identifier/Client ID Number: xxx
(If available) Application number: xxx
Your current status in Canada: VISITOR - IMPLIED STATUS
The expiration date of that status:
xx xx 2014 - I applied for OWP Extension with my PR application so currently I have an implied status.
Complete address (including the postal code). If the residential address is different from the mailing address, please provide both addresses:
xxx
TORONTO, ONTARIO - xxx
Telephone number. If you have more than one contact number, please provide them all: xxx-xxx-xxxx
xxx-xxx-xxxx
Date the application was submitted: xxxx xx xx
The address where the application was sent:
CPC-Mississauga
P.O. Box 5040, Station B
Mississauga, ON
L5A 3A4
(if applicable) The postal company and tracking number if you sent your application via registered mail:
CANADA POST XPRESSPOST xxxxxx
SPONSOR - SPOUSE:
Surname - Exactly as it appears on the passport or identity document: xxx
Given name(s) - Exactly as it appears on the passport or identity document: xxx
Date of birth (YYYY-MM-DD): xx
Country of birth: xx
(If available) Universal Client Identifier/Client ID Number: -
(If available) Application number: xx
Your current status in Canada: CITIZEN
The expiration date of that status: N/A
Complete address (including the postal code). If the residential address is different from the mailing address, please provide both addresses:
xxx
TORONTO, ONTARIO - xx
Telephone number. If you have more than one contact number, please provide them all: xxx-xxx-xxxx
xxx-xxx-xxxx
Date the application was submitted: xx xx 2014
The address where the application was sent:
CPC-Mississauga
P.O. Box 5040, Station B
Mississauga, ON
L5A 3A4
(if applicable) The postal company and tracking number if you sent your application via registered mail:
CANADA POST XPRESSPOST xxxx
Silence.C said:
Help!!! I Received AOR on Aug 7th.Status Available on Ecas Sep 30th. I went for Upfront medical exam today Oct 1st. And I got a paper call "Emedical informatiob sheet with barcode and UMI number. Then what should I need to do? Sent this form via email, post mail or just wait CIC update my Ecas automatically? Thanks ???
We got an email today from our representative. She has received our entire application back saying it is incomplete! On the 5 of August she had received just one form back to be signed again since I had signed in the wrong place, my mistake. At that time she suggested that we include the new form on dependents since my son was not wanting to join me and is now 19, he was 18 when we submitted the first time. We signed this new form and she sent the form that I had to resign back as well. Now nearly 2 months later we are receiving the entire application back even though the new forms are in the application they are saying it is not there. Our Rep has scanned everything and sent it to me show show me what she got back and everything is there. 
