Medical certificate for Spanish visa: the IHR-2005 explained

The medical certificate of good health is one of the documents generating most rejections in consular visa files. The reason is not medical: the certificate gets rejected because the text signed by the doctor does not literally mention the International Health Regulations of 2005 (IHR-2005, RSI-2005 in Spanish). For the consulate, without that mention the certificate doesn't meet the legal requirement — even if the applicant is perfectly healthy.

This guide explains what the certificate must say, which doctors issue it in each country, what happens with the apostille, and what the sworn translation reaching the file looks like.

Which visas require it and which don't

The medical certificate of good health is mandatory in the following Spanish consular processes:

Not required in the following cases:

• Renewals from within Spain of any of the above (only for consular initial visa).
• Residence authorisation applications submitted from within Spain (DGGM 5/2025 criterion).
• TIE and modality changes already residing in Spain.
• Spanish citizenship by residence.

This last point (not requested from inside Spain) is important: if the applicant is already in Spain and will submit the application at the local Immigration Office, no medical certificate is needed even if it's their initial procedure.

What the certificate must say

The required literal wording in English (UK/US model):

"[Patient name] does not suffer from any of the diseases that may have serious public health repercussions in accordance with what is stipulated by the International Health Regulations of 2005"

In Spanish:

"[Nombre del paciente] no padece ninguna de las enfermedades que pueden tener repercusiones de salud pública graves de conformidad con lo dispuesto en el Reglamento Sanitario Internacional de 2005"

In French:

"[Nom du patient] ne souffre d'aucune des maladies pouvant avoir des répercussions graves sur la santé publique conformément aux dispositions du Règlement Sanitaire International de 2005"

Some consulates additionally require mention of absence of drug addiction and absence of mental illness:

"…nor does the patient suffer from drug addictions, substance dependencies or mental illnesses that could pose a danger to themselves, the community or third parties."

What is the IHR-2005

The International Health Regulations 2005 (in Spanish Reglamento Sanitario Internacional de 2005, RSI-2005) is a World Health Organization treaty adopted by the 58th World Health Assembly. Spain ratified it in 2007. Its objective is to identify, prevent and control the international spread of diseases that may constitute a public health emergency.

The IHR-2005 defines "diseases with potential serious public health impact" with an evolving list that currently includes:

• Smallpox, polio (wild strain), human pandemic influenza, SARS, MERS, COVID-19.
• Cholera, plague, yellow fever, viral haemorrhagic fevers (Ebola, Lassa, Marburg).
• West Nile Virus, dengue, Rift Valley fever.
• Invasive meningococcal disease.

The certificate affirms that the patient shows no clinical evidence of any of these diseases — it is not an exhaustive screening with blood tests, but the doctor's professional opinion after patient assessment.

Who issues the certificate in each country

🇺🇸 United States

Any MD licensed in the US (state medical board licence) can issue the certificate. Typical providers:

• CityMD, Concentra, MedExpress — urgent care clinics offering "visa medical" as a standardised product. Cost: $100-200. Same-day result.
• MDs in private practice with their own template. Usually requires scheduled appointment.
• Travel clinics specialised in travel medicine (Passport Health, etc.).

Important: the doctor must sign and seal the certificate and provide their state medical license number. The apostille is then arranged at the Secretary of State of the doctor's state.

🇬🇧 United Kingdom

• NHS GPs (private appointments — the NHS does not issue these certificates for visas).
• Private GPs with their own practice.
• Specialised providers like ZoomDoc Health or GP Matters Glasgow — they issue the certificate pre-formatted with the IHR-2005 wording included, QR code, doctor's GMC number. Cost: £60-100. Same-day result.
• BMI, Spire, Bupa private clinics.

The apostille is placed by the FCDO Legalisation Office in Milton Keynes.

🇫🇷 France

• Médecins généralistes (GPs) with practice. Important that the doctor includes their RPPS number (Répertoire Partagé des Professionnels de Santé).
• Centres de santé (municipal or association-based).
• Specialist doctors (cardiologists, endocrinologists) when patient history justifies.

Apostille: the French medical certificate does not benefit from EU Reg 2016/1191 (which only covers civil status). It still needs apostille — placed by the Cour d'appel territorially competent.

General EU countries

• Germany (Hausarzt with Approbation) — apostille from issuing Land.
• Italy (medico di base) — apostille from Procura della Repubblica.
• Netherlands (huisarts) — apostille from District Court.

The EU Regulation 2016/1191 trap

Many believe that since EU Regulation 2016/1191 removes apostille between EU States for civil status, it also does so for medical certificate. It does not: EU Reg 2016/1191 covers birth, marriage, death, criminal record and a few more, but does not include medical certificates.

Therefore, a French, German or Italian medical certificate destined for a Spanish consulate still requires apostille.

Temporal validity

The certificate has 3 months validity from issue date. If your consular appointment is more than 3 months away, the consulate rejects it as expired. Request the certificate close to submission date, not months in advance.

Sworn translation of the certificate

Once you have the original certificate + apostille (if applicable), it gets translated by a MAEC-accredited sworn translator-interpreter. The translation includes:

• Patient identification.
• Doctor's data (name, professional registration number, specialty, centre).
• Literal declaration on absence of IHR-2005 diseases.
• Specific enumeration of diseases if the certificate lists them.
• Declaration of absence of drug addiction and mental illness if included.
• Medical centre seal, doctor's signature, date and place.
• Verification codes (QR, reference number ZDVAP-, etc.).
• Apostille translated (if applicable).

At Textualia we have the complete medical certificate technical fact sheet with all country models and the exact format Spanish consulates accept.

Common mistakes

1. Certificate without IHR-2005 reference. The doctor issues a standard "fitness to travel" not mentioning the regulation. The consulate rejects. Solution: tell the doctor the exact wording before the appointment.
2. Expired certificate at submission. Three months pass fast. Request close to consular appointment.
3. Confusing certificate with exhaustive examination. It's not a screening with blood and urine; it's the doctor's professional assessment after consultation.
4. Not apostilling (where applicable). For UK, US, FR, AU, etc. certificates, apostille is mandatory.
5. Assuming EU Reg 2016/1191 avoids apostille. It does not cover it.
6. Non-sworn translation. An "ATA translation" or a freelance translator without MAEC accreditation doesn't qualify.
7. Missing or illegible professional registration number. The GMC in UK, RPPS in FR, state medical license in US must appear legibly.
8. Name discrepancies between certificate and passport. Ask doctor to use exact passport name (no nicknames, no abbreviated legal name).

Related pages

• Sworn translation of medical certificate of good health — complete technical fact sheet with country models.
• Spain Non-Lucrative Visa for US citizens
• Hague apostille by country: 2026 table
• Complete catalogue of documents

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