Canada


Basic information

Documentation is processed electronically using “e-Medical“ on-line system. Please use our contact form to make an appointment. On the day of your examination please bring with you all items listed here on our websites; all forms should be in actual versions.

The medical examination is focused on the evaluation of physical and mental status. This represents the complex examination including vision examination, blood pressure measurement (15 years and older) and urinalysis. Urine sample is provided by the applicant during the examination. Urine sample is requested from the age of 5 years, in women out of menstruation period. Chest X-ray is requested from the age of 11 years. The examination duration varies roughly from 1 to 2 hours per person depending on certain request, health status of the applicant and additional examinations (X-ray, blood sampling, etc.).


Medical examination(you were referred by the embassy following your visa application and IME number was allocated to you)

Please take with you:

Following 3 Forms (printed)

  • IMM 1017 Client Biodata (issued by the embassy individually)
  • IMM 5743 Client Consent (please print it out from the embassy websites)
  • IMM 5419 Medical Report (please print it out from the embassy websites and fill in just your personal data in the header of each page, please print out one-sidedly)

Original passport + copy of the passport (page with photo)

Contact details of the applicant (residential address, e-mail, cell phone number) and the type of visa; to be written on a passport copy

2 passport format photos

Prescription (eye) glasses or contact lenses, if applicable

In case of any chronic diseases or congenital problems please provide existing specialist´s report

Pediatrician´s report in children under 18 years of age


Medical examination ”up-front“ (you were not referred by the embassy and IME number was not allocated to you so far,  you are planning to submit the exam confirmation together with your visa application)

Please take with you:

Following 2 Forms (printed)

  • IMM 5743 Client Consent (please print it out from the embassy websites)
  • IMM 5419 Medical Report (please print it out from the embassy websites and fill in just your personal data in the header of each page, please print out one-sidedly)

Original passport + copy of the passport (page with photo)

Contact details of the applicant (residential address, e-mail, cell phone number) and the type of visa; to be written on a passport copy

2 passport format photos

Prescription (eye) glasses or contact lenses, if applicable

In case of any chronic diseases or congenital problems please provide existing specialist´s report

Pediatrician´s report in children under 18 years of age

Advanced payment is requested

Contact for examination for Canada:

Jitka Patočková MD

Vítězné nám. 9, 160 00 Praha 6

Tel. +420 605 76 36