Immigration Medical Toronto Intake Form

Immigration Medical Toronto Intake Form

Please complete this form as soon as possible. Please complete one form for EACH person. Complete the form carefully as this information will be entered into your profile.
Appointment Date - Please Enter Your Confirmed Time As Per Email/Booking Page*

MonthDayYear
Date
Appointment Time - Please Enter Your Confirmed Time As Per Email/Booking Page*

Hour Minutes

AM/PM Option
Permanent ResidencyRefugeeWork PermitStudent VisaVisitor VisaUkraine Medical Diagnostic Test (Must have CUAET Approval Letter for Port of Entry Facilitation)Streamlined Immigration Medical Exam (Preapproval from IRCC Required)
YESNO
Enter IME Number (8 digit number):*
For Express Entry applicants - Please upload your Invitation To Apply (ITA) Letter if you have one. Please upload the same form for each family member. Please see below for example. If you do not have a form, please skip this step. You may still complete your medical exam in preparation if you do not have an Invitation To Apply (ITA).

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Identification Document Details

Please enter information carefully
ID That You Will Be Bringing To Appointment - Passport PREFERRED and HIGHLY RECOMMENDED. For refugee claimants, please bring REFUGEE PROTECTION CLAIMANT DOCUMENT or ACKNOWLEDGEMENT OF CLAIM AND NOTICE OF INTERVIEW.*
Document Number*
Issuing Country*
UCI Number*
Date of Issue*

MonthDayYear
Date
Expiry Date

MonthDayYear
Date
Upload a PDF or JPEG copy of your ID*

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Terms & Conditions
Immigration Medical Toronto is a fully eMedical enabled clinic. We also use multiple technologies to help make your visit with us convenient, efficient, and accurate. Any collection of personal health information is stored in encrypted and HIPAA (Health Insurance Portability and Accountability Act) complaint tools. Occasionally, you may request to communicate with us electronically through email which is not. Please read our email policy in the link below.

As part of your medical exam, applicants Age 15+ will require a blood test which is a mandatory component of the immigration exam. This involves a needle venipuncture blood draw. Common side effects of this procedure include pain at the injection site, bruising, or hematoma afterwards. To minimize this, please make sure to place pressure and hold the injection site for atleast 3-5 minutes after the procedure, avoid heavy lifting or vigorous exercises for 24 hours, and elevate your arm. By checking the box below, you understand the risks and benefits and consent to procedure.
Please check the information entered carefully prior to hitting the SUBMIT button. Any errors you enter will be entered into your profile, so please check your information carefully.
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Identifying Details