This form is a medical declaration for visa applicants requiring a chest x-ray examination. It includes sections for the applicant to provide personal information, consent to the Department retaining medical information, and declare if pregnant or wish to defer the exam until after giving birth. Sections for radiographers, radiologists, and department officials to complete are also included.
The form and report should be returned directly to the officer of the Department specified in the covering letter, or to the return address specified on the form. If the x-ray was taken in Australia, local arrangements may apply for returning the package.
The film should bear the date of examination, the applicant's family and given names, HAP ID (if available), and the name of the clinic. For pregnant women, the film must have double abdominal shielding.
The radiologist must certify that they have carried out the x-ray and write their signature, date, full name, contact telephone number, country code area code number, address, and email address on the form. They must also grade the examination using the provided grading system, with supporting comments if necessary.
Yes, the Australian Department of Home Affairs provides a form named 'Medical Examination for Humanitarian Entrant or Return Migrant (HEAR) – Pregnant Woman' which outlines the requirements and declarations for pregnant women undergoing chest x-rays during their immigration health examinations.
The form advises using a large (14 x 17 inch) posteroanterior film, strict field size limitation, and double abdominal shielding to minimize radiation exposure to the developing fetus. The radiographer must also certify that they have carried out the x-ray with these precautions.
The form requires the pregnant woman to provide her personal details, such as name, date of birth, and contact information. She must also sign a declaration stating that she has consulted with her doctor or radiologist about the risks and benefits of undergoing a chest x-ray while pregnant, and that she wishes to proceed with the procedure.
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