Your Highness said:
Thank you for your response Fast track. Could you share with me the contents (minus the personal details) of those individual medical forms that you rcvd for each dependant?
Hello friends,
I need your inputs please. I have received only 4 PDFs.
CIIP
Cost recovery fees
Medical Instructions A
Request letter
I haven't rcvd any forms. It that a cause for worry? What's your advice?
Waiting eagerly to hear form you all.
Thanks
Citizenship andCitoyenneté etPROTECTED WHEN COMPLETED -B
Immigration Canada Immigration Canada
MEDICAL REPORT:
Section A
Client Identification & Summary
Office
Application
no.
New Delhi
UCI
IME no.
E0000
Family name
Given name(s)
Date
of birth
MonthYear Day
Country of birth
Gender
Application category
SW1-FED
Required for all applicants.
Must be taken within six months
of the medical examination.
Mailing address (for us
India
Marital stat
Province of destination
E-mail
Telephone no.
Contact Address/Person within Canada (name, full address and telephone number)
PHYSICIAN'S SUMMARY AND DECLARATION BASED ON HISTORY AND PHYSICAL EXAMINATION
X
check off ALL appropriate item(s):
A.
A.A.Findings that are unremarkable or minor conditions which normally respond well to short term office/outpatient treatment. SURGERY IS NOT
REQUIRED. Applicant can be followed by a general practitioner and will have minimal requirements for hospitalization or social services. NO ACTIVE TB OR
DANGEROUS BEHAVIOUR. (e.g. NORMAL CHILDREN, 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 self-sufficient, etc.)
B.
Findings that require periodic specialist follow-up care but which normally can be handled without resorting to repeated hospitalizations 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 unlikely over the next 10 years, well controlled rheumatoid arthritis with a minimal functional impact, etc.). Applicant should be able to function independently
and be self-sufficient (no anticipated need for domiciliary or nursing home care in the future). No evidence of mental retardation or developmental delay. NO
ACTIVE TB OR DANGEROUS BEHAVIOUR. At most only minor hospitalizations.
C.
Findings that may require more extensive investigations or care. Applicants where:
(1) HOME/INSTITUTIONAL SUPERVISION AND CARE is needed,
(2) MAJOR OR RECURRENT HOSPITALIZATIONS are likely (especially for procedures involving joint replacements, transplantation, cardiac surgery,
subspecialist care, etc.),
(3) SPECIALIZED HOSPITAL FACILITIES such as DIALYSIS units, CANCER outpatient clinics,
(4) There is a need for use of intermittent/continuing SOCIAL SERVICES, or SPECIALIZED EDUCATION/VOCATIONAL TRAINING,
(5) DETERIORATION appears likely,
(6) The normal acquisition or maintenance of SELF-SUFFICIENCY APPEARS DOUBTFUL,
(7) ACTIVE TB 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 last two years,
especially when associated with impaired driving or legal difficulties).
EXAMPLES: Dementia and psychiatric disorders causing clinically significant distress or impairment in social, occupational or other important areas of
functioning; renal insufficiency, diabetic nephropathy or patients on renal dialysis or renal conditions with the potential for deterioration; symptomatic heart disease of
any cause, or symptomatic peripheral vascular disease or symptomatic cerebro-vascular disease, or functional impairment due to strokes etc.; Parkinsonism;
multiple sclerosis or genetic/inherited or other conditions likely to create a functional deficit; follow-up for neoplastic disorders; chronic infections or degenerative or
auto-immune conditions with complications or requiring long term treatment.
D. Other conditions/disorders difficult to categorize OR where there is a lack of sufficient medical information.
ALSO MARK HERE IF APPLICANT IS CURRENTLY A REFUGEE/REFUGEE CLAIMANT
Physician's full name, address and telephone number
Place of examinationSignature
Date
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.
Month
Office stamp may be used
DayYear
IMM 1017 (05-2010) E GCMS
(DISPONIBLE EN FRANCAIS -IMM 1017 F)
