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Chinese Health Examination

Certificate of Health Examination for International Traveller (August 2010)

Many foreigners are unsure of all the requirements and regulations surrounding this mandatory health check.

We will define the main reasons for needing one, describe what is entailed, and clear up some area's of confusion and misinformation.

China Expats Director Jonno has now taken this examination (August 2011) and you can read his personal account here

Important Points:

1. You will generally need to undergo a Chinese medical examination to work in China, or for any visa that runs for 12 months or more. Common types of inclusions and exceptions are:
      a. 1 or 2 year business (F) visa
            i. This visa typically has a maximum single entry stay of 30 days only, so does not require a health check.
      b. 6-month student visa or 'X' visa
            i. This exception does require a health check.
      c. All applications for a work visa or 'Z' visa require a health check.
      d. Residence visa's or 'D' visa's require a health check.
            i. The new 6-month Family Visit visa does not require a health check, as this is a Tourist or 'L' visa
            ii. Family Visit visa's for 1 or 2 years do require a health check. This is because they are a 'D' visa.

There are many other criteria, so please regard the above as highlighting the most common that ordinary people will encounter in China.

Details of the medical examination are as follows:

Certificate of Health Examination for International Traveller

Updated 15th August 2010

Where examined   You can only be examined at a specified County Level, government hospital. Therefore even though you may live in a large modern city, there may not be an approved hospital that can be used.
What you need 1. Your passport (With current visa; and Certificate of Temporary Residency if applicable to yourself?)
2. One copy of each material page of above (Personal information page, page(s) showing last visa and entry stamp (Not always on the same page).
3. Five photographs of the specified standard. Any registered photography shop will know which type you need. There will also be a suitable shop very near the hospital. Often only two photographs are required.
4. The fee (Expect change from 500 RMB).
Before going 1. Do not have breakfast on the day of the examination.
2. If taking medication, continue to take this and inform the Doctors or staff upon registration for the exam. Perhaps best to take it with you?
What is checked? The Ministry of Public Health and the Ministry of Public Security, check for the following: The medical examination includes:

1. Height, Weight, Blood pressure, Body temperature, Internal medicine, EENT; B-ultrasound (liver, gallbladder, spleen and kidneys), EKG, Chest X-Ray, Laboratory tests: Blood Routine, Blood type, Urinalysis, HIV, TPPA, Hepatitis B surface antigen, Anti-HCV, ALT etc.
Persons to be employed in the catering industry will have a stool culture test.

2. Infectious diseases under surveillance; Including: Influenza, Poliomyelitis, Malaria, Dengue fever, Relapsing fever, Epidemic typhus and AIDS (including HIV infection). This also includes Hepatitis B, Plague, Cholera, Yellow fever and other infectious disease which are as announced and confirmed by the State Council.

3. Entry is also forbidden in cases of the following diseases; including: Severe Psychosis Infectious Tuberculosis disease, Any other infectious diseases which can endanger public health or security severely.

4. If you show symptoms of any of the above mentioned, you will not be issued with a Certificate.

This is perhaps the one time when you should carry your Home Country vaccination certificate with you. For Example:

You do not need the Cholera vaccination to enter China, although most western health practitioners recommend it (It is not required generally). Teachers coming to work in China will need a health check as part of their 'Z' visa application, which is done within 30 days of entry. The Cholera vaccination will still be active in your system during this time ... which could lead to serious complications!
Examination The examination nominally takes about 30 minutes, and many people are processed at the same time. If there are a lot of people, then expect this to take about one hour. The order may vary, but here is what happens:

1. Bloodwork. They should always use new sterile needles.
2. Ultrasound.
3. ECG.
4. Eye tests.
5. Weight, height, etc.
6. Internal Medicine:
        a. Blood pressure and Chinese pulse checks (Traditional method using fingers on wrist).
        b. Breathing - stethoscope and all that stuff.
7. X-ray of torso.

You should be done now, but there are another 30 tests that could be performed.
How long does the Certificate take to process? The stated period of processing is 3 working days (May exclude week-ends).
Re-examination Occasionally people are required to submit to a further examination. This may be because something unusual was found, or because records got muddled somewhere.

For re-examination, take with you all the documents from last time + your receipt of initial examination.

1. If something unexpected was found then you will be subject to a further investigation of that specific area or problem.
2. If you simply take the whole examination again, then it is likely your original test was muddled in some way.
3. There should not be any extra charge for re-examination, although you will be liable to pay in advance for any resulting treatment.
Bloodwork Many re-examinations are concerned with Bloodwork. This is because more than 99.9% of Chinese people have rhesus positive blood. A large number of Foreigners may have rhesus negative blood. During examination you will be told what your blood group is, and if it is negative then please check this is marked accordingly on your sample.

Chinese do take a lot of blood from you during this phase, as many tests are conducted using it. If you feel unwell after blood is taken, then ask to rest for a few minutes - this will not adversely affect your test results.

Other Information

Having the Examination Abroad

Health examinations can be performed abroad. For physicals performed abroad, you must go to Exit-Entry Health and Quarantine Bureau with the following:
a) a doctors letter stating you are healthy.
b) original copies of all blood tests, X-rays, EKG/ECG readouts, and other required tests.
Each individual test result should be clearly identified as belonging to you.
c) Completed Health Certificate Application Form (available at the Health & Quarantine)

Many foreigners have problems with this, basically because the results are not indexed and presented according to how the Chinese want them. Most westerners simply present a home country certificate and expect this to be enough. It is not enough! You need to be presenting a thick file with every single result of each required Chinese test, and each is identified officially as belonging to you. It is far easier (And cheaper) to just go for the Chinese one in China.

The second problem is that foreigners do not submit this to the right place. Often this may be due to a 'helpful' Chinese friend placing your correct file with the wrong people. You best do this yourself and go to the main regional branch of the Exit/Entry PSB dealing.

The Bottom Line
If you expect China to accept your medical examination from Home Country, then you need to be very specific and focus on minute details. Better just get it done in China for a fraction of the cost.

Applying for 'Z' visa in home country

The Chinese system does not work this way in practice, as you are expected to arrive in China Mainland on a Tourist ('L') visa, and then have 30-days grace period for your authorised employer to action your 'Z' visa (At no charge to yourself - including the Medical Exam).

We have read in some forum's about horror stories concerning 'Z' visa applications in USA and UK. As an individual, please know you should never be in a situation where you have to apply for a Chinese 'Z' visa in your home Country!

If you do apply for a Z visa in Home Country, then know you have opened a 'can of worms'! Basically the rules for issuance of a Z visa only apply internally to China; and there is no separate external application. Therefore all these poor people applying in USA are doing so with rules that only apply inside China.

Best advice:
Get a Tourist ('L') visa and apply for your Z visa once you are physically in China - that's how the system works!

There can be bureaucratic red tape when applying for anything, whether it's a travel visa or a Title Max loan. While a Title Max loan may be easier to apply for than a visa for travel to another country, being prepared to provide all the necessary information is to be expected for both.
This information is as supplied by China Expats and the Chinese Ministry of Public Security (PSB) as dated 15th August 2011; and/or other reliable sources. Please check this information yourself as it may alter without notice, and whilst we try our best to ensure it is correct, please do not hold us responsible for any errors - this is intended as a simple guide only
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