RCMP-GRC 2082E: Medical examination certificate

Medical examination certificate PDF, 710KB)

Protected "B" when completed

Privacy notice

This form must be completed electronically. If not possible, please complete it in dark ink using capital letters.

Plan member's personal information
Preferred language

Instructions for the plan member

The medical examination shall be taken within six months before or six months after the date the service buyback form is signed which includes the RCMP-GRC A-2-2E, RCMP-GRC 3006-1 and/or RCMP-GRC 3006-2.

  1. Arrange with the physician of your choice to be medically examined. Note that the physician must have the authority to practice medicine in the jurisdiction in which the examination is performed. (Any cost incurred to complete this form is the contributor's responsibility)
  2. Have the examining physician complete the certificate below
  3. Return the completed certificate to the Government of Canada Pension Centre
Certification of physician

I, the undersigned physician, certify that I have medically examined the above-mentioned person and his/her health justifies a life expectancy of at least 5 years from this date.

Please send the compeleted form to:

Government of Canada Pension Centre—Mail facility
150 Dion Boulevard
PO Box 8500 
Matane QC  G4W 0E2

RCMP- GRC 2082E (2014-07-001)

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