al report on chest x-.pdf

160 (Design date 04/12) - Page 1? COMMONWEALTH OF AUSTRALIA, 2012 Radiological report on chest x-ray of an applicant for an Australian visa Form 160 Forms 1071i Health requirement for permanent entry to Australia and 1163i Health requirement for temporary entry to Australia provide information on Australia’s health requirements. The Department of Immigration and Citizenship (the department) is authorised to collect and use the personal information on this form under section 60 of the Migration Act 1958. When you complete this form and give it to the doctor or clinic, the Commonwealth of Australia becomes the owner of the information on the form. The doctor is required to send the form to the department. Your responsibilities The costs of medical examinations are paid by you directly to the doctors or clinics undertaking the examinations. There may be additional costs if further tests or couriers are required. Outside Australia If outside Australia you must attend the same radiology clinic during the course of your medical examinations. If you are an applicant for a visa under Australia’s Offshore Refugee and Special Humanitarian Program the Australian Government provides arrangements to cover the costs of your medical examinations. In Australia If you are in Australia and you have applied for a protection visa, special arrangements may apply in regard to the costs of medical examinations. Visa subclass and visa name To assist the department to link your medical examinations with your visa application you must write the visa subclass number and the name of the visa you are applying for on page 4 of this form. For example: ? Subclass 176 – Skilled-Sponsored (Migrant) ? Subclass 405 – Investor Retirement ? Subclass 679 – Sponsored Family Visitor ? Subclass 890 – Business Owner (Residence). This information is required for the visa decision-maker to process your visa application. You can find the visa subclass number and the name of the visa on