01 CANADA Checklist - v1
01 CANADA Checklist - v1
01 CANADA Checklist - v1
APPLICANT’S NAME: LAST NAME, First Name, Middle Name AGE: Age
MOBILE NO: At least 2 mobile numbers EMAIL ADDRESS:
COMPLETE HOME ADDRESS: House No / Unit No / Building, Street Valid e-mail address
Barangay, Municipality/City, Province
TYPE OF VISA: Ex: Student, Work, Visitor, Permanent / Temporary Resident, etc.
TYPE OF MEDICAL EXAMINATION: WITH IME (IMM 1017E) UPFRONT MEDICAL EXAM
* Note: Please print out a copy of this checklist and bring along with your compiled requirements and printed forms (per applicant) on your
medical examination appointment date.
REQUIREMENTS
PLEASE BRING ONLY IF APPLICABLE
Reference: IOM MHC_Canada IME Requirements
Medical Report Form (IMM 1017E) Pertinent medical reports / results
* Sent by IRCC (skip if you are for Upfront Medical * If applicants have significant medical history or undergoing
Examination) treatment
Letter of Authorization
* From the parent sponsoring the visa application (signed)