Medical Application Form

Please note: This form is only for international student applicants. If you are a returning resident, please download the appropriate form off the fees and applications page.

 

General Information

Please include area code

All information in this form is confidential.

***Note: You DO NOT need your doctor to fill out this form. If you have any questions please contact sloewen [at] tyndale [dot] ca (S)sloewen [at] tyndale [dot] ca (hannon Loewen), Residence Director.
Emergency Contact Information
Please provide dates of most recent immunizations

In order to complete the medical form you must have a recent tuberculosis(TB) skin test performed. Please record the result and date of the test below. If you have not yet completed a TB skin test, you can email the result to admissions [at] tyndale [dot] ca (Admissions). You cannot be a Tyndale resident unless we have the result of your TB skin test.

Have you ever had the following