I, too, received a letter for medical. I am a single applicant. July 2011. The lady from vegreville phoned me asking me to fax my passport so I asked her about the medical report received attached with aor, she said I don't need to go for medical it's just an automated thingy that's the reason why the medical was attached. Right now, I'm just waiting for my csq kit. I am from montreal btw. I've also bugged the call center regarding this, they told me I have to do it while some agents would say that I don't need to do it.