About the document
- Country:
- Thailand
- Category:
- Medical and insurance
- How to fill:
- Chat in any language → original form → PDF
- Price:
- form free · chat ฿49 per document
- Last updated:
What this document is
The Medical Certificate is a one-page English form published by the Ministry of Foreign Affairs of Thailand for the Royal Thai Embassy in Ottawa, Canada. It is used when applying for the long-stay Non-Immigrant O-A visa.
The examining doctor states their licence and certifies that the patient is free of five diseases — leprosy, tuberculosis, elephantiasis, drug addiction and third-stage syphilis — and is in good physical and mental health. The doctor signs the certificate.
Who fills it in
- the Non-Immigrant O-A visa applicant (the patient) — may pre-fill their name and date of birth;
- the doctor — examines the patient, writes in (or checks) their own details and the dates, and signs.
The form does not state requirements for the doctor (for example, where they must be licensed) or how recent the certificate must be — check with the embassy or consulate where you apply.
What the form asks for
- date of the certificate;
- the doctor’s name, medical licence number and date of issue;
- the patient’s name (three times, in the three sentences of the statement) and date of birth;
- date of examination;
- the doctor’s signature, name in print, clinic address and telephone.
The list of diseases is printed on the form and is not filled in.
Where to submit it and what to attach
The certificate is attached to the Non-Immigrant O-A visa application submitted to a Royal Thai Embassy or Consulate — now usually through the official e-Visa system (thaievisa.go.th). Check the full list of documents, fees, processing times and whether the certificate must be certified with the embassy or consulate for your country.
How to fill it in with FoxDocs
- Open the chat on this page and answer the questions in any language.
- Give your name as in your passport and your date of birth, plus the doctor’s details if you already know them.
- Check the fields and download the PDF.
- Take the form to your medical examination: the doctor adds the dates, checks the details and signs.
Sources
Royal Thai Embassy Ottawa Medical Certificate form on the Thai MFA website: image.mfa.go.th. Checked on 2026-10-08. This is not legal or medical advice.