Medical Examination for Immigrant or Refugee Applicant
Canadian Examination Forms
OMB # 1405-0113
Justification
As per previous OMB agreement, Canadian versions of the medical exam forms are available. This submission updates these forms.
The Canadian version of these forms are used the same way the regular medical forms are used, but they are only available from US Embassy and Consulates in Canada, for use in Canada.
The reason these forms were developed is because the group insurer for most Canadian physicians refuses to cover them for any legal actions brought within the US. The CMPA (the group insurer) decided they would accept the liability if we provide the doctors with examination forms that don't say they are from the USG and do not have any US indicia on them.
Burden information does not change as these forms have been included in the overall aggregate burden calculations.
| File Type | application/msword |
| File Title | Medical Examination for Immigrant or Refugee Applicant |
| Author | R. A. Ciupek |
| Last Modified By | R. A. Ciupek |
| File Modified | 2009-04-09 |
| File Created | 2009-04-09 |