Medical Examination for Relocation: Designated Clinics and Re-examination Requirements

Quick Summary: For U.S., Canadian, Australian, and New Zealand relocation programs, a medical examination is only valid when conducted by a doctor or clinic designated by the immigration authority — examinations elsewhere, even at prestigious hospitals, will not be accepted. Caribbean investment citizenship programs use their own medical forms, which must be signed by a licensed physician. After your examination, your work is not finished: results have an expiration date, and suspected tuberculosis on chest X-rays is the most common reason people delay their applications for months.

A family of five we once assisted had prepared everything for their relocation medical examination: fasting since the night before, bringing all passports, photos, and completed forms. The father was healthy and a non-smoker. Two days later, the clinic reported a shadow on his chest X-ray and requested sputum testing.

The shadow was a scar from a lung infection when he was ten years old — he had forgotten about it. Sputum culture results took approximately eight weeks to return. The entire family waited for him.

This story is not uncommon. It is simply rarely mentioned beforehand.

Which relocation categories require designated clinic examinations?

Not all applications require medical examinations, and not all examinations are the same. The table below shows the general framework as of 2026; verify the specific details with the current immigration authority guidelines for your category.

The list of designated doctors and clinics in your country is published by each immigration authority and changes periodically. Check the official immigration website immediately before scheduling your appointment; do not rely on contacts who were examined years ago.

What does a relocation medical examination include?

For U.S., Canadian, and Australian programs, a typical examination includes:

• Medical history and general examination: heart, lungs, blood pressure, vision, neurological function, mental health assessment.
• Chest X-ray for applicants from a certain age onward (typically age 15 and above; some programs require it from age 11).
• Tuberculosis testing for children using the screening method specific to each country.
• Blood and urine tests according to the program's requirements, such as syphilis and HIV screening in some countries.
• Vaccination verification — for U.S. permanent residency specifically, immigrants must have all required vaccinations according to the CDC schedule; any missing vaccines are administered at the clinic.

Caribbean programs are simpler: the program's medical form, a general examination by a physician confirming absence of serious infectious disease, and certain blood tests per the form. The examination can be at any reputable hospital, but the medical form must exactly match the program's template with all required signatures and stamps. A standard Vietnamese health certificate form will not be accepted. The article from signature to passport receipt for Caribbean citizenship shows where this step fits in the complete application process.

Why do chest X-rays cause the longest delays for applicants from Vietnam?

Vietnam is classified as a high-burden tuberculosis country by the World Health Organization. Immigration authorities of relocation countries therefore scrutinize chest X-rays from Vietnamese applicants more carefully.

Many middle-aged applicants have scarring or calcifications from a tuberculosis or pneumonia infection in childhood that never caused symptoms. On an X-ray, these marks prevent the doctor from ruling out active tuberculosis, triggering the sputum culture requirement. Bacterial culture results take up to approximately eight weeks.

If results are negative, the application proceeds. If positive, the applicant must complete full treatment before the application can continue — adding many more months of delay.

While you cannot avoid sputum testing if such findings appear, you can help the doctor make a faster assessment:

• If you previously had tuberculosis, bring your treatment records and proof of completed treatment.
• If you have old chest X-rays, bring them for comparison — findings unchanged over many years are important information.
• Provide complete and honest medical history. Concealing illness and having it discovered on imaging is much harder to explain.

Checklist for your medical examination

• [ ] Original passport for each person being examined.
• [ ] Appointment letter or examination instructions from the immigration authority, application number.
• [ ] Photographs per the clinic's requirements (some clinics take photos on-site).
• [ ] Vaccination record booklet for children; vaccination records for adults if available.
• [ ] Medical records for chronic conditions; list of current medications.
• [ ] Tuberculosis treatment records and old chest X-rays if applicable.
• [ ] Eyeglasses if worn regularly — vision examination is assessed with corrected vision.
• [ ] Program-specific medical form with personal information pre-filled (for Caribbean citizenship programs).

Ask the clinic in advance whether fasting is required; not all programs require it. Pregnant women should notify the clinic in advance for guidance on chest X-ray procedures.

When re-examination is required

This is often where families encounter unexpected delays. Common situations we have seen:

1. Results expire before visa issuance. The application is delayed for other reasons — processing backlogs, requests for additional documents — and the medical examination expires. Re-examination and fees are required.
2. Results expire before arrival in the destination country. Some programs issue visas with an expiration date linked to the examination date. Missing this deadline means restarting from the medical examination step.
3. Suspected tuberculosis or other findings requiring follow-up. Sputum culture, treatment, then re-examination for confirmation.
4. Birth of a family member. A baby born during processing must be added to the application and examined separately.
5. Major change in health status during application processing: surgery, newly diagnosed illness — some programs require disclosure.
6. Errors on the medical examination form — incorrect name, date of birth, passport number. Small mistakes sometimes necessitate a complete re-examination. See also common errors with photos, signatures, and biometrics.

Timing of your medical examination is therefore a strategic decision: examining too early risks expiration, examining too late means your application waits for you.

Risks to understand beforehand

• Certain health conditions can affect approval. Beyond infectious diseases, countries like Canada and Australia also assess anticipated medical costs to their public systems. Chronic illnesses requiring expensive ongoing care can become problematic. If your family includes such a person, consult an immigration attorney before submitting your application.
• Elderly parents are the most vulnerable point. Common age-related conditions in people age 60–70, combined with chest X-ray findings from old infections, create complications; read more about elderly parents accompanying adult children abroad.
• Examination fees are not included in initial quotes. Clinic examination fees, supplemental vaccination fees, and re-examination fees are all the applicant's responsibility.
• Do not open sealed envelopes containing results. If the clinic provides a sealed envelope, opening it voids the examination result.
• Passing the medical examination does not guarantee public health insurance coverage. Having a valid health status does not mean you can immediately use public healthcare; see public and private healthcare in investment program countries.

This article provides information about procedures and is not medical or insurance advice.

Questions to ask your relocation consultant

1. Which clinic should I use for my program, and when was the designated clinic list last updated?
2. What is the optimal timing for my medical examination based on my current application timeline?
3. How long are my results valid, and who will notify me if re-examination is needed due to application delays?
4. If family members have a history of tuberculosis or chronic illness, what additional preparation is recommended?
5. Are medical examination fees, supplemental vaccines, and potential re-examination fees included in the budget?

Next steps

Before receiving your examination appointment letter, do one simple thing: ask each family member — especially grandparents and middle-aged relatives — whether they have ever had lung disease, tuberculosis treatment, or chest X-rays. Locate old medical records if they exist. One evening spent organizing paperwork can eliminate two months of waiting.

If you are still choosing between programs, compare options using this criterion as well: programs requiring designated clinic examinations typically add an extra processing step that Caribbean investment citizenship or European Golden Visa programs do not have.