Part E – Health details
31 In the last 5 years, have you visited or lived outside your country of passport for more than 3 consecutive months?
35 During your proposed visit to Australia, do you expect to incur medical costs, or require treatment or medical follow up for:
• blood disorder;
• cancer;
• heart disease;
• hepatitis B or C and/or liver disease;
• HIV Infection, including AIDS;
• kidney disease, including dialysis;
• mental illness;
• pregnancy;
• respiratory disease that has required hospital admission or oxygen therapy;
• other?
No
Yes Give details
36 Do you require assistance with mobility or care due to a medical condition?
No
Yes Give details
37 Have you undertaken a health examination for an Australian visa in the last 12 months?
No
Yes Give details (including HAP ID if available)
Note: If you are applying for a long stay Visitor visa or are 75 years or over, you will be asked to undergo a health assessment and may be asked to show that you have medical insurance to cover your intended stay in Australia. Please contact your nearest office of the department for further advice before lodging your application. If additional medical consultations are required, a decision on your visa application will be delayed.
Do not include time spent in Australia.
No
Yes Give details
1. Country(s)
DAY Date from
2. Country(s)
DAY Date from
MONTH
MONTH
MONTH
YEAR DAY to
YEAR DAY to
YEAR DAY to
MONTH YEAR
MONTH YEAR
MONTH YEAR
3. Country(s)
Date from
DAY
If insufficient space, give details at Part O
32 Do you intend to enter a hospital or health care facility (including nursing homes) while in Australia?
No
Yes Give details
33 Do you intend to work as, or study to be, a doctor, dentist, nurse or paramedic during your stay in Australia?
No
Yes Give details
34 Have you:
• ever had, or currently have, tuberculosis?
• been in close contact with a family member that has active
tuberculosis?
• ever had a chest x-ray which showed an abnormality?
No
Yes Give details
Part E – Health details31 In the last 5 years, have you visited or lived outside your country of passport for more than 3 consecutive months?35 During your proposed visit to Australia, do you expect to incur medical costs, or require treatment or medical follow up for:• blood disorder;• cancer;• heart disease;• hepatitis B or C and/or liver disease;• HIV Infection, including AIDS;• kidney disease, including dialysis;• mental illness;• pregnancy;• respiratory disease that has required hospital admission or oxygen therapy;• other?NoYes Give details36 Do you require assistance with mobility or care due to a medical condition?NoYes Give details37 Have you undertaken a health examination for an Australian visa in the last 12 months?NoYes Give details (including HAP ID if available)Note: If you are applying for a long stay Visitor visa or are 75 years or over, you will be asked to undergo a health assessment and may be asked to show that you have medical insurance to cover your intended stay in Australia. Please contact your nearest office of the department for further advice before lodging your application. If additional medical consultations are required, a decision on your visa application will be delayed.Do not include time spent in Australia.NoYes Give details1. Country(s)DAY Date from2. Country(s)DAY Date fromMONTHMONTHMONTHYEAR DAY toYEAR DAY toYEAR DAY toเดือนปีเดือนปีเดือนปี3. country(s)วันที่เริ่มต้นวันถ้าไม่เพียงพอพื้นที่ ให้รายละเอียดที่ส่วน O32 คุณไม่ต้องป้อนกับโรงพยาบาลหรือดูแลสุขภาพสิ่งอำนวยความสะดวก (รวมถึงสถานพยาบาล) ในขณะที่ในออสเตรเลียไม่ใช่ใช่ให้รายละเอียด33 ทำคุณตั้งใจทำงานเป็น หรือศึกษาให้ แพทย์ ทันตแพทย์ พยาบาล หรือ paramedic ถือในออสเตรเลียไม่ใช่ใช่ให้รายละเอียด34 คุณมี:•เคยมี หรือ ได้ วัณโรค•การติดต่อใกล้ชิดกับสมาชิกในครอบครัวที่มีใช้งานอยู่วัณโรคหรือไม่•เคยมีเอ็กซ์เรย์หน้าอกซึ่งแสดงให้เห็นว่ามีความผิดปกติหรือไม่ไม่ใช่ใช่ให้รายละเอียด
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