Form B1 Instructions

Form B1: Medical Practitioner's Form for Category 1 Applicants

Make an appointment with your doctor. Get two ( 2 ) passport photos taken. You will need these for Form A. He or she will need to fill out Form B1 or B2, and sign your photos to indicate that this is a true likeness of you.

Please note that either a Form B1 OR a Form B2 is required to apply for an MMAR card.  Both forms can be completed, however only one form is necessary to apply.  To clarify the difference between Category 1 applicants and Category 2 applicants, see Eligibility.

Health Canada Form B1 Medical Practitioner's Form for Category 1 Applicants

B1-1: Information on Medical Practitioner

• Your doctor will fill in the top part of this form.

B1-2: Medical Condition and Symptoms

• Print your name, birth date and telephone number
• Your doctor will fill in the rest of this section

B1-3: the Proposed Daily Amount

• This will be filled in by your doctor.  

B1-4: Duration

• This will be filled in by your doctor

B1-5 Medical Practitioners Declaration and Signature

• This will be filled in by your doctor