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- Do you currently hold, or have you ever held, citizenship of any other country?*
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- Start Date*
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- Start Date*
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- When do you plan to travel?*
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- Have you ever applied for or obtained a visa, an eTA or a permit to Canada?*
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- Have you ever been refused a visa or permit, denied entry to, or ordered to leave Canada or any other country?*
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- Have you ever committed, been arrested for, or convicted of any criminal offence in any country?*
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- In the past two years, were you diagnosed with tuberculosis or in close contact with a person with tuberculosis?*
- Is your contact with tuberculosis the result of being a health care worker?*
- Have you ever been diagnosed with tuberculosis?*
- Do you currently have any of the following untreated conditions? Untreated syphilis, untreated drug or alcohol addiction, or untreated mental health condition with psychosis.*
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