Important: Toronto Public Health does not see clients in person for TB IMS services. Please do not visit a City of Toronto Office.

 

Tuberculosis Immigration Medical Surveillance (TB IMS) is a requirement of Immigration, Refugees and Citizenship Canada (IRCC) for specific individuals coming to Canada.

When you apply to come to Canada to live, work, study, or visit for six months or more, IRCC requires that you complete an Immigration Medical Exam (IME) by a designated medical practitioner (DMP).

If it is written on your IME report that you have inactive TB or had TB disease in the past, you will be required to have a second TB medical check-up after you arrive in Canada, as you have a higher risk of getting sick with TB in the future. TB IMS helps to protect your health, your family and the public.

Important: If you live in Toronto, do not come to a City of Toronto office. We do not see clients in person for TB IMS.

To start the TB IMS process:

1. Contact your local public health unit

If you live in the City of Toronto (your postal code begins with “M”), there are two ways to start TB IMS:

  1. You can complete the TB IMS form online.
  2. You can call Toronto Health Connections at 416-338-7600. Interpreters are available if you speak another language.

You must contact the public health unit where you live.  If you live outside the City of Toronto (your postal code does not start with “M”), find your local public health unit.

2. See a doctor or nurse practitioner

After you submit your TB IMS information to Toronto Public Health (TPH), a TB nurse will review your information and send you the following:

  • A TB medical assessment form.
  • Instructions for your next steps.

This may take up to six months. Take the TB medical assessment form to a doctor or nurse practitioner of your choice.  TPH does not see clients for medical appointments.

If you do not have a family doctor or nurse practitioner, you can find a doctor or nurse practitioner.

Your doctor or nurse practitioner will:

  • Complete the form.
  • Order a chest x-ray.
  • Order other tests if necessary.

Ask your doctor/nurse practitioner to send your completed form and test results to TPH by fax at (416) 338-8149.

3. Get your TB immigration medical surveillance compliance letter

After TPH receives all of your medical reports, a TB nurse will review your file.

If no further check-up is needed, the nurse will notify IRCC that you have complied with the requirements of TB IMS.

You will receive a letter from your TB nurse as proof of your compliance.  This usually takes about four to six weeks after your doctor or nurse practitioner submits your medical reports.

If you’ve reported to TPH and have changed your address, email, phone number, or if you are leaving the province or country, update your information.

Before you begin:

  • If you have a TPH Respondent ID number, please have it ready. You would have received this if you completed the TB IMS form online.
  • If you do not have a TPH Respondent ID, you can still complete this form.

Most people in Toronto complete TB IMS within six months, but it may take up to a year in some cases.

Toronto Public Health will provide you with a due date to complete your medical check-up.

The cost of TB IMS 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 the Ministry of Health’s Apply for OHIP and Get a Health Card.

If you are waiting for OHIP coverage to start

If your OHIP coverage will begin in a few months, you can wait to book your TB medical check-up until you have OHIP coverage.

If you develop symptoms of TB disease, please contact your doctor or nurse practitioner or seek medical care right away.  Please notify us afterward by calling Toronto Health Connections at 416-338-7600 and ask to speak with a TB nurse so that we are aware of your symptoms.

If you have private health insurance:

  • Contact your insurance provider to find out what services are covered.

If you do not have private health insurance:

  • You will need to pay for your medical check-up and any tests that are required.
  • Costs can vary.

If you do not have health coverage, you can find help through these resources:

    IRCC has referred you for TB Immigration Medical Surveillance (TB IMS). This means there is a condition on your immigration file, which will be removed after you complete TB IMS.

    Border officials may ask about it when you return to Canada because your Medical Surveillance requirement with IRCC is not complete.

    Before leaving Canada, you must tell both IRCC and Toronto Public Health.

    1. Notify IRCC: Email the Public Health Liaison Unit at Immigration, Refugees and Citizenship Canada (IRCC) at MHBSurveillance-SurveillanceDGMS.IRCC@cic.gc.ca

    Include the following information found on your immigration documents:

      • Your full name
      • Unique Client Identifier (UCI)
    1. Notify TPH: Update your information online or call Toronto Health Connections at 416-338-7600 to update us by phone.

    If you have any questions about why you were placed on TB IMS, please contact Immigration, Refugees, and Citizenship Canada.

    If you are diagnosed with TB infection:

    • You are not sick (TB bacteria is not active in your body)
    • You cannot spread TB to others

    However, TB infection can become TB disease in the future.

    There is free medication you can take to prevent TB disease.  TPH provides free TB medication to anyone living in Toronto, regardless of their immigration status or health insurance coverage.

    After your TB medical check-up:

    • Your doctor or nurse practitioner may recommend TB preventive treatment.
    • This treatment helps stop TB from becoming active in your body in the future.

     Important:

    • Taking medication for TB infection does not affect your TB immigration medical surveillance or your immigration status.

    If you are diagnosed with TB disease, a TB nurse from TPH will work with you and your doctor or nurse practitioner during your treatment.

    Being diagnosed with TB disease does not affect your immigration status in Canada or your family’s status.

    TB medication is free in Ontario.  We can help get you medical care, even if you do not have health insurance.

    Symptoms of TB disease

    • Cough, lasting more than two weeks
    • Worsening cough or coughing up blood
    • Fevers or chills
    • Night sweats
    • Unexplained weight loss
    • Feeling very tired (fatigue)

    If you develop symptoms before your TB IMS medical check-up:

    • Contact your doctor or nurse practitioner or seek medical care right away.
    • Please notify us afterward by calling Toronto Health Connections at 416-338-7600 and ask to speak with a TB nurse so that we are aware of your symptoms.
    Date modified: July 21, 2026