HELPING HANDS CANADIAN IMMIGRATION CONSULTANCY
CANADA VISITOR VISA (TRV) / SUPER VISA
CLIENT ASSESSMENT & INTAKE FORM
For internal use only — to be completed by client before file preparation, each adult accompanying should fill their separate form
Date:
Instructions Note: This form is used only to prepare your application file and is not submitted to IRCC.
1. Application Details
Purpose of Trip — describe in detail (who you are visiting, activities planned, places to see, dates)
2. Applicant Information
Passport – please share all copies of your current passport and any old passports, if applicable.
Are you a lawful permanent resident of the U.S. (Green Card holder)? Yes No
Have you held a Canadian visitor visa in the past 10 years? Yes No
Do you currently hold a valid U.S. non-immigrant visa? Yes No
3. Citizenship and Places Lived
Are you a citizen of more than one country?
Yes No
National Identity Document (e.g., Aadhaar / voter ID / other national ID)
Do you have a valid national identity document? If yes, please share it with this assessment form.
Yes No
Have you used another name in the past (maiden name, alias, name change)?
Yes No
Please explain (other name(s), and when/why used)
4. Contact Information
Residential Address
Is your mailing address the same as your residential address?
Yes No
Mailing Address (if different)
Applicant's Personal Contact Details
5. Biometrics
In the last 10 years, have you provided biometrics (fingerprints and photo) for any Canadian visa, extension, restoration, work permit, or study permit application?
Yes No
Provide details (date you gave biometrics, location, application type)
6. Invitation Information (Host(s) in Canada) – Inviter(s)
Complete one block per inviter. Use the + button to add more inviters.
+ Add another inviter (e.g., spouse of Inviter 1)
Has someone else also invited you?
Yes No
Please explain (who, and why they invited you)
7. Finances
How much money do you have for your stay in Canada? (CAD)
Is someone else giving you money for your stay in Canada?
Yes No
8. Education, Work and Other Activities
Have you ever studied at a post-secondary school (university, college or vocational school)?
Yes No
Education details after +2 (Senior Secondary School)
+ Add another qualification
Did you serve in any military, militia, civil defence unit, security organization or police force?
Yes No
Please explain (unit, rank, dates, country)
Current / Most Recent Work or Activity, then Employment History
Add the current or most recent job first, then earlier jobs. Use the + button to add more (copy of the "Employment History Continues" table).
Work / Activity × Remove
Main duties of the job
+ Add another job / activity
9. Travel History
During the past 5 years, have you travelled to a country/territory other than the one where you are a citizen or currently live?
Yes No
List countries visited, city names and travel dates
+ Add another trip
Have you ever stayed in Canada beyond the validity of your status, studied in Canada without authorization, or worked in Canada without authorization?
Yes No
Have you ever been refused a visa or permit, denied entry to, or ordered to leave any country/territory? (share refusal notes)
Yes No
If yes to either question above, provide full details (country, date, reason)
10. Criminality and Security
Have you ever committed any crime in any country/territory (including driving under the influence)?
Yes No
Have you ever been arrested for any criminal offence in any country/territory?
Yes No
Have you ever been charged for any criminal offence in any country/territory?
Yes No
Have you ever been convicted of any criminal offence in any country/territory?
Yes No
Are you or have you ever been a member of or associated with any group/organization that has engaged in or advanced violence for a political or religious objective, or been associated with criminal activity?
Yes No
Have you ever witnessed or participated in the ill treatment of prisoners or civilians, looting, or desecration of religious buildings?
Yes No
If yes to any question above, provide full details (Schedule 1 disclosure will be required)
11. Medical Background
Have you had a medical exam performed by an IRCC-authorized panel physician within the last 12 months?
Yes No
In the last 2 years, were you diagnosed with tuberculosis?
Yes No
In the last 5 years, have you been in close contact with a person with tuberculosis?
Yes No
Are you currently receiving dialysis treatment?
Yes No
Have you had a drug or alcohol addiction causing you to be a threat to yourself or others, or to be hospitalized?
Yes No
Have you had a mental health condition causing you to be a threat to yourself or others, or to be hospitalized?
Yes No
Have you ever been diagnosed with syphilis?
Yes No
If yes to any question above, please explain (for the exam: panel physician name, date and location)
12. Family Information
Current marital status
Single / never married Married Common-law Separated Divorced Widowed
Spouse / Common-Law Partner
Is their address the same as yours? Yes No
Will your spouse/partner accompany you to Canada? Yes No
Children (biological, adopted, or step-children)
Do you have any children?
Yes No
Parents
+ Add another parent
13. Supporting Documents Collected
Check off as each item you are submitting with this form.
Other (specify)
14. Consultant Assessment Notes OFFICE USE ONLY
Internal client notes.
Strength of ties to home country
Credibility of purpose of trip
Adequacy of financial evidence
Dual intent / prior refusal considerations
Overall risk assessment and recommended next steps
Client signature (acknowledging information provided is accurate)
15. Important Documents VISITOR VISA & SUPER VISA
Note: Some of these documents may or may not be applicable to your case. If you have any confusion, please reach out to us.
Tick what you can provide now. Items marked "Super Visa only" apply only if you are applying for a Super Visa.
A. Documents from the Applicant(s) — Visitor Visa and Super Visa
B. Documents from the Inviter / Host in Canada — Visitor Visa and Super Visa
C. Additional Requirements — Super Visa only (Parents and Grandparents)
D. Information We Will Need from the Parent Applicant(s) — Super Visa only
E. Forms and Payment
We will prepare these with you; some need your signature. If you are unsure which apply, ask us.
Notes / questions about the documents above