* Required Applicant information First name Last name Date of birth Licence number (if applicable) Email address Requestor information Are you contacting us on the applicant’s behalf? No, the request is for myself Yes Your relationship to the applicant Parent Spouse Flight instructor Member of Parliament Other: please specify Other Contact information Your first name Your last name Email Request information What is the purpose of your enquiry? I want an update on the status of the medical certificate application I want to confirm that you have received all the necessary information to process the medical certificate application I received confirmation that my medical certificate was issued, but I have not received a printed copy I have questions regarding the medical certificate application process in general Other… Other: please specify Are you inquiring about a first application or a renewal? First application Upgrade Renewal Category of medical certificate requested Category 1 Category 2 Category 3 Category 4 Date of last medical examination Location of last medical examination - None -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonOutside of Canada: please specify Country Country - None -CanadaGreenlandSt. Pierre & MiquelonUnited StatesBelizeCosta RicaEl SalvadorGuatemalaHondurasMexicoNicaraguaPanamaAntigua & BarbudaBahamasBarbadosBermudaBritish Virgin IslandsCayman IslandsCubaDominicaDominican RepublicGrenadaGuadeloupeHaitiJamaicaMartiniqueMontserratCuraçaoArubaSint MaartenCaribbean NetherlandsPuerto RicoSt. BarthélemySt. Kitts & NevisAnguillaSt. LuciaSt. MartinSt. Vincent & GrenadinesTrinidad & TobagoTurks & Caicos IslandsU.S. Virgin IslandsArgentinaBoliviaBrazilChileColombiaEcuadorFalkland IslandsSouth Georgia & South Sandwich IslandsFrench GuianaGuyanaParaguayPeruSurinameUruguayVenezuelaAustriaBelgiumFranceGermanyLiechtensteinLuxembourgMonacoNetherlandsSwitzerlandBulgariaBelarusCzechiaEstoniaHungaryLatviaLithuaniaMoldovaPolandRomaniaRussiaSlovakiaUkraineDenmarkFaroe IslandsFinlandÅland IslandsIcelandIrelandNorwaySvalbard & Jan MayenSwedenUnited KingdomGuernseyJerseyIsle of ManAlbaniaAndorraBosnia & HerzegovinaCroatiaGibraltarGreeceVatican CityItalyMaltaMontenegroPortugalSan MarinoSerbiaSloveniaSpainNorth MacedoniaKosovoCape VerdeBeninGambiaGhanaGuineaCôte d’IvoireLiberiaMaliMauritaniaNigerNigeriaGuinea-BissauSt. HelenaSenegalSierra LeoneTogoBurkina FasoBurundiComorosMayotteEthiopiaEritreaDjiboutiKenyaMadagascarMalawiMauritiusMozambiqueRéunionRwandaSeychellesSomaliaZimbabweSouth SudanUgandaTanzaniaZambiaAlgeriaLibyaMoroccoSudanWestern SaharaTunisiaEgyptAngolaCameroonCentral African RepublicChadCongo - BrazzavilleCongo - KinshasaEquatorial GuineaGabonSão Tomé & PríncipeBotswanaLesothoNamibiaSouth AfricaEswatiniAfghanistanAzerbaijanBahrainArmeniaCyprusGeorgiaPalestinian TerritoriesIranIraqIsraelKazakhstanJordanKuwaitKyrgyzstanLebanonOmanQatarSaudi ArabiaSyriaTajikistanUnited Arab EmiratesTürkiyeTurkmenistanUzbekistanYemenChinaTaiwanHong Kong SAR ChinaJapanNorth KoreaSouth KoreaMacao SAR ChinaMongoliaBruneiMyanmar (Burma)CambodiaIndonesiaLaosMalaysiaPhilippinesTimor-LesteSingaporeVietnamThailandBangladeshBhutanBritish Indian Ocean TerritorySri LankaIndiaMaldivesNepalPakistanAmerican SamoaAustraliaSolomon IslandsChristmas IslandCocos (Keeling) IslandsCook IslandsFijiFrench PolynesiaKiribatiGuamNauruNew CaledoniaVanuatuNew ZealandNiueNorfolk IslandNorthern Mariana IslandsU.S. Outlying IslandsMicronesiaMarshall IslandsPalauPapua New GuineaPitcairn IslandsTokelauTongaTuvaluWallis & FutunaSamoaAntarcticaBouvet IslandFrench Southern TerritoriesHeard & McDonald Islands Has a Transport Canada employee already been in contact with you about this application? No Yes Date of last letter from Civil Aviation Medicine (if applicable) Not applicable Date of last submission of additional documents to Civil Aviation Medicine (if applicable) Not applicable Date of last letter from Civil Aviation Personnel Licensing (if applicable) Not applicable Additional comments. Terms and conditions The Government of Canada will read comments and participate in discussions when appropriate. Your comments and contributions must be relevant and respectful. The Government of Canada will not engage in partisan or political issues or respond to questions that violate these Terms and Conditions. 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