TB medical surveillance is a medical check-up for a person who is newly arrived in Canada to check that they do not have active TB disease. This is a requirement of Immigration, Refugee and Citizenship Canada (IRCC).

  1. When you apply to come to Canada for six months or more, to live, work, or visit, you have to complete an immigration medical exam (IME). The IME is reviewed by IRCC to check for many illnesses including TB.
  2. If you are found to be well but have a history of TB or possible inactive TB infection, this means you have a higher risk of getting sick with TB in the future. You will be approved to come to Canada, but you will need to complete medical surveillance once you arrive (or after you get your immigration papers if you applied from within Canada).
  3. If you are found to have active TB disease on the immigration medical exam, you must be treated before being allowed to enter Canada. You will also need to complete medical surveillance once you arrive.
  4. Those who are placed on medical surveillance will be given instructions by IRCC to report to their local public health unit. They will be given a Medical Surveillance Undertaking form (IMM 535) or mailed an In-Canada Public Health follow-up letter.

  1. If you live in the City of Toronto, you must call Toronto Public Health (TPH) at 416-338-7600 within 30 days of coming to Canada or getting the In-Canada Follow-up letter or within seven days if you have been identified as an urgent referral.
    You should say you live in Toronto and need to report for TB medical surveillance. A TB nurse will speak with you. The nurse will ask for your name, address, immigration information, and ask you about your health, including past history of TB. The nurse may also ask you for a copy of your IMM 535 form or In-Canada Follow-up letter. If you do not speak English, you may ask someone to speak for you.
  2. Your TB nurse will send you a TB medical assessment form and a letter with instructions on how to complete TB medical surveillance.
  3. Bring this letter to a health care provider (HCP) of your choice in Ontario. The HCP will ask health questions, order a chest x-ray and other tests if necessary. After all the tests are done, make sure your HCP faxes your completed form and test results to TPH at fax 416-338-8149.
  4. Once all of your medical reports have been received by TPH, your TB nurse will review them. The nurse may contact you if further follow-up is required.
  5. TPH will notify IRCC that you have complied with the requirements of TB medical surveillance. TPH will send you a letter as proof of compliance. You should keep this letter with your immigration documents. You do not need to send the letter to IRCC.

The average time for medical surveillance in Toronto is six months. Toronto Public Health will provide you with a due date to complete your medical check-up.

The cost of TB medical surveillance in Ontario can be covered by the Ontario Health Insurance Plan (OHIP). To find out if you are eligible, please call the Service Ontario INFOline at 1-800-268-1154 or visit their website to apply for OHIP and get a health card.

Being diagnosed with active TB disease does not affect your immigration status in Canada.

If you have active TB disease, a TB nurse from TPH will work with you and your HCP while you are being treated. TB treatment is free of charge in Ontario even if you do not have health insurance. TB medical surveillance is a requirement by IRCC – IRCC calls it a condition of landing. You will need to go for TB medical surveillance check-up before this condition is removed from your immigration file.

If you do not complete medical surveillance, IRCC may not give you a visa extension, student/visitor permit, permanent residency and even Canadian citizenship. You will have to get the TB medical surveillance check-up before they will accept any new applications from you.

If you leave the country before completing TB medical surveillance you may be questioned at the border/airport the next time you try to return to Canada.

Notify Toronto Public Health:

  • If you change your address while you are on TB medical surveillance
  • If you are going to travel outside of Toronto for more than one month.
  • If you develop signs and symptoms of active TB while you are completing your medical surveillance, speak to your doctor right away and call Toronto Public Health.

New to Canada and living in Toronto? Learn about other health services for newcomers.