School of Canada Inc.
455 Spadina Ave., Suite 300, Toronto, Ontario M5S 2G8
(416) 323-1818 Toll Free (800) 263-1703 Fax (416) 323-1681
Medical Form to be Filled out by Doctor
Please print and take this medical form to your doctor (M.D.) to be filled out.
( ) Is the above in good health and free of communicable diseases?
( ) Results of T.B. Test
Is the above named person fit, healthy and able to work with the public?
( ) Yes ( ) No
If No, please explain why. Thank You
Doctor's Name (please print) Doctor's Signature