Designated Medical Practitioner Handbook
Appendix XIV: DMP Acceptance of Appointment Form
DMP Acceptance of Appointment Form
I ______________________________________________________,
of
(First Name, Initial, Surname)
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(Practice address)
Accept the offer of appointment as a practitioner performing Canadian immigration medical examinations. I acknowledge that I have read, understand and accept the instructions, directions and guidelines in the Handbook for Designated Medical Practitioners.
I understand that by accepting this appointment, I agree to undertake Canadian immigration medical examinations in the manner and format defined and directed in the handbook. The handbook sets out the rules and standards of my appointment. I also agree to adhere to and follow the policies, procedures and guidance outlined in the handbook and/or provided by CIC medical officials, and any changes to these policies and procedures as may be made by CIC from time to time.
_______________________________________
(Print Name)
Date: _______/_____/_____
YYYY MM DD
_______________________________________
(Signature)
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Appendix XIV:
DMP Acceptance of Appointment Form
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