HEALTH EXAMINATIONS LIST

This list identifies all of the applicants who have made a combined visa application, whoare required to undergo health examinations, to ensure they meet the health requirement for

an Australian 576 - AusAID/Defence Sponsored Sector visa.

The required health examinations are listed against each applicant below.

Please make sure that you read this document and provide it to the clinic undertakingyour health examinations.

Required health examinations

- FAZIAMain Applicant:01 July 1987Date of Birth:A2212528Passport Number:INDONESIAPassport Country:

*HAP_3951180*3951180HAP ID:

Medical Examination●

Chest x-ray●

The forms used for your health examinations are:Medical Examination (Form 26)●

Chest x-ray (Form 160)●

Where do I get the forms?

If the required forms are not attached to this list, you can download paper forms from the websiteof the Department of Immigration and Citizenship (DIAC) atwww.immi.gov.au/allforms/health-requirements/ . This is not required if you intend to completeyour health examinations electronically (using eHealth or eMedical).

Arranging your health examinations outside Australia

Required health examinations for visa applicants outside Australia are conducted by qualifieddoctors and radiologist nominated by the department. A list of approved immigration panelphysicians is available on the department’s website at www.immi.gov.au/contacts/panel-doctors/

6 Chan Street Belconnen ACT 2617PO Box 25 BELCONNEN ACT 2616 • Telephone: 02 6264 1111 • Fax: 02 6225 6970 • www.immi.gov.au

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Panel physicians in your country may have access to process your health examinations using asecure online system called eMedical or eHealth. These are DIAC’s online systems for recording,processing and storing the health assessment results for Australian visa applications.We encourage you to use electronic health processing where available, as it helps DIAC tofinalise your health results quickly – typically within 48 hours. To find out which panel clinics

in your country offer online processing, look for the eHealth logo [ ] or eMedical logo [ ]on the list of the approved immigration panel physicians.

Arranging your health examinations in Australia

Required health examinations for visa applicants in Australia are conducted by MedibankHealth Solutions (MHS) or an Approved Medical Practitioner (AMP) if you are in a regionalarea.

Please contact your nearest MHS office to make a booking to undergo the health assessmentsthat are listed above for each applicant.

The preferred method of contacting MHS is via their online booking service atwww.medibankhealth.com.au.

However, you should telephone MHS if you wish to arrange a family appointment or if you arein a country area to obtain the name of an AMP closest to you. MHS can be contacted on 1300361 046.

What do I need to know about eMedical?

If you complete your health examinations electronically at an eMedical enabled clinic, theclinic will record your consent to use the system electronically on your behalf. A copy of thedeclaration that will be stored in eMedical is provided below.

If you are going to attend an eMedical enabled clinic, it is very important that you read thisdeclaration so that you understand your responsibilities in terms of the information you provideduring the health examination process, and are aware of how DIAC will collect and use yourpersonal health information before you attend the clinic – as eMedical clinic are expected toprocess all health examinations electronically except where otherwise advised by DIAC. If youhave any concerns about this, you should discuss them with the DIAC before booking a medicalappointment.

I declare that the information that I have provided in terms of my medical history and during my immigration healthexaminations as recorded in eMedical is true and correct.

I understand that:if I have provided any false or misleading information to the Department of Immigration and Citizenship (DIAC)as part of my immigration health examination, my visa application(s) may be refused and/or any visa subsequentlyissued cancelled

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the Commonwealth of Australia becomes the owner of the information entered into eMedical and that thisinformation will be passed to DIAC;

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DIAC is authorised to collect and use the personal information entered into eMedical under section 60 of theMigration Act 1958;

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6 Chan Street Belconnen ACT 2617PO Box 25 BELCONNEN ACT 2616 • Telephone: 02 6264 1111 • Fax: 02 6225 6970 • www.immi.gov.au

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if the information I have provided is not stored within the eMedical System, then the processing of my visaapplication will be delayed, as required health examinations must be completed and assessed prior to a visadecision being made;

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DIAC has a privacy policy that contains information about how I can access the information stored in eMedical,seek the correction of such information, complain about a breach of any Australian privacy laws or codes of

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practice that apply to DIAC, and how DIAC deals with such complaints. This privacy policy is available athttp://www.immi.gov.au/allforms/pdf/993i.pdf;DIAC's contact details are outlined on its website at: http://www.immi.gov.au/contacts/ ; and●

further information about eMedical is also available on the DIAC website at:http://www.immi.gov.au/allforms/health-requirements/electronic-health-processing.htm

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I consent to:my medical information being submitted to DIAC for the purposes of assessing my health for current or futureAustralian visa applications;

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DIAC retaining my medical information, including any x-ray images uploaded to eMedical, beyond the finalisationof my visa application, for the purposes of considering future applications I may make for a visa to Australia;

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DIAC disclosing my personal information, including information about my health, to the radiologists/panelphysicians who have examined me. The reasons for this disclosure will be to investigate inconsistencies between

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the radiologist and/or panel physician’s examination and a previous/subsequent health assessment, to investigatea complaint against the radiologist or panel physician, and to follow up adverse results with the radiologist orpanel doctor to ensure the quality of the work undertaken by Australia's panel physicians network; andDIAC storing my digital photograph(s) which may be used by DIAC for client identification purposes in additionto the health examination process.

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I understand that my personal information (including my sensitive information) stored in eMedical (includingmedical results, bio details and digital photographs) may also be disclosed to:

Australian Government health agencies, health and settlement service providers and examining doctor(s);●

Australian Government agencies authorised to receive information relating to adoption, border control, businessskills, citizenship, education, health assessment, health insurance, health services, law enforcement, payment

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of pensions and benefits, taxation, superannuation, review of decisions, child protection and registration ofmigration agents;Australian law enforcement, health agencies and international agencies, including overseas recipients in theUnited Kingdom, the United States of America, Canada and New Zealand, for the purposes of identity checking.

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[Note: if you are applying for a refugee or humanitarian visa, the department will only disclose this informationto another country if it is reasonably satisfied that this information will not be disclosed to your country ofclaimed persecution].

6 Chan Street Belconnen ACT 2617PO Box 25 BELCONNEN ACT 2616 • Telephone: 02 6264 1111 • Fax: 02 6225 6970 • www.immi.gov.au

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