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IRCC IMM 5419: Paper Immigration Medical Report

Where eMedical is not available and the Regional Medical Office approves paper submissions, panel members record the immigration medical examination on this multi-part report. It covers medical history questions, the physical examination, the laboratory requisition and report, and the chest x-ray requisition and report. It accompanies the paper Client Biodata and Summary (IMM 1017).

Who completes it

The panel physician reviews the medical history (which clinic staff or the applicant may fill in) and completes the physical examination; the laboratory completes the laboratory requisition and report; and the panel radiologist grades and signs the chest x-ray report. Sample collectors and radiographers confirm the client's identity against the attached photo.

Submitting and payment

How to submit it
Paper IMEs go to the Regional Medical Office only with the RMO's approval; panel members in countries where eMedical is implemented must use eMedical instead.
Who pays
The applicant pays the panel physician for the immigration medical examination, unless the exam is covered by the Interim Federal Health Program.

Good to know

  • Every yes answer to a history question needs the date of diagnosis, treatment or surgery dates, relevant medications and current status, in the comments or an attached report.
  • A positive HIV serology result requires the counselling confirmation form (IMM 5728); the laboratory section also covers syphilis serology and serum creatinine as indicated.
  • Pregnant clients may defer the chest x-ray: the IME is completed except for the x-ray and is sent only after the post-partum chest x-ray returns (IMM 5733).
  • The panel physician's name and unique identifier must be readable on the laboratory and chest x-ray sections, and the photos attached there must match the applicant.

Get the official form

Download the current version from the source each time; forms change without notice.

Medical Report (paper-based immigration medical examination)

Rapport médical

Official page

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

When is the paper IMM 5419 used instead of eMedical?

Only by panel members without eMedical access. IRCC requires panel members in countries where eMedical is implemented to complete and transmit all IMEs electronically; otherwise the Regional Medical Office may allow paper-based IME results, following the paper instructions in Section 2 of the Panel Members' Guide.

Which conditions do not affect the immigration medical assessment?

The guide lists examples such as treated hypertension, thyroid disease, asthma and allergies, pregnancy-related history, past injuries with normal function, stable musculoskeletal conditions, cosmetic surgery, obesity, dental findings and professional tattoos. These are recorded as normal history with comments and graded A if nothing else is significant.