One of the required steps in the U.S. immigration process—whether you’re applying for a green card through adjustment of status or consular processing—is completing a medical examination conducted by a USCIS-approved civil surgeon. This step is critical because your application for lawful permanent residence cannot be approved without it.
The immigration medical exam isn’t something to fear, but it must be taken seriously. A poorly prepared applicant may face delays, rejections, or requests for additional testing. This guide will help you understand what the exam involves, how to prepare properly, and how to avoid common errors.
What Is the Purpose of the Immigration Medical Exam?
The exam is meant to ensure that applicants do not have any medical conditions that would make them inadmissible to the United States. Specifically, it evaluates:
- Communicable diseases of public health significance (e.g., tuberculosis, syphilis)
- Proof of required vaccinations
- Drug or alcohol abuse that poses a threat
- Mental or physical disorders associated with harmful behavior
The medical findings are documented using Form I-693, Report of Medical Examination and Vaccination Record, and submitted to USCIS.
Step 1: Find a USCIS-Approved Doctor
You cannot go to just any doctor. The medical exam must be conducted by a physician designated as a USCIS civil surgeon (for applicants in the U.S.) or a panel physician (for applicants abroad).
To find a USCIS-approved doctor:
Visit the USCIS official website tool here: Find a Civil Surgeon
- Enter your zip code or city
- Choose from the list of authorized providers
- Call ahead to confirm availability, cost, and required documents
Fees are not set by USCIS and vary depending on the doctor.
Step 2: Gather Required Documents
Before your appointment, make sure to gather:
- Government-issued photo ID (passport, driver’s license, or green card)
- Form I-693 (you can bring it blank or partially filled but do not sign it until instructed by the doctor)
- Vaccination records, preferably in English or with certified translations
- A list of current medications
- Any prior medical records related to significant conditions
Having organized, translated records can prevent delays or misinterpretation.
Step 3: Understand the Vaccination Requirements
USCIS requires proof of specific vaccines based on CDC guidelines. These include but are not limited to:
- Measles, mumps, and rubella (MMR)
- Hepatitis A and B
- Influenza (seasonal)
- Varicella (chickenpox)
- Tetanus, diphtheria, and pertussis (Tdap)
- COVID-19 (required unless waived)
If you are missing any, the civil surgeon may offer them on-site or refer you to a clinic. Partial or outdated records may require revaccination unless medically contraindicated.
Step 4: What Happens During the Exam
Expect a standard physical check-up along with specific screenings:
- Height, weight, and blood pressure check
- Vision and hearing test
- Blood test (for syphilis for applicants 18+)
- Urine test (for gonorrhea for applicants 18+)
- Tuberculosis screening: this may include a chest X-ray, especially for applicants age 2 and older
- Review of vaccination history
- Questions about drug/alcohol use and any history of mental illness
The doctor will complete Form I-693 with your results. Do not open the sealed envelope the doctor gives you. It must remain sealed when submitted to USCIS.
Step 5: Common Mistakes to Avoid
- Bringing incomplete or untranslated vaccination records – This can delay your results or lead to unnecessary vaccinations.
- Showing up late or unprepared – Confirm your appointment time and what documents to bring.
- Failing to disclose prior medical history – The civil surgeon needs complete and honest answers to assess eligibility.
- Opening the sealed envelope – USCIS may reject opened or altered medical forms.
Step 6: Submitting the Medical Exam to USCIS
There are two ways to submit your completed Form I-693:
- Submit it at the same time you file your green card application (Form I-485)
- Bring it to your green card interview or submit it after receiving a request from USCIS
To avoid delays, it’s often recommended to complete your medical exam close to the time of filing Form I-485. The form is valid for two years if properly completed and signed by both you and the doctor.
USCIS-Related Insights
- If you’re unsure whether to submit the medical exam with your initial application, speak with a legal consultant or attorney.
- USCIS will issue a Request for Evidence (RFE) if Form I-693 is missing or incomplete.
- Always keep a personal copy of your completed Form I-693 and vaccination summary.
Documentation Tips
- Translate all foreign-language records into English with a signed certificate of translation
- Bring original and copy versions of your vaccine cards and ID
- Create a folder labeled by section (ID, vaccinations, medical history) to stay organized
FAQ
1. How much does the immigration medical exam cost?
There’s no fixed price—it varies by location and provider. You can expect to pay between $150 and $500. Always confirm in advance.
2. Do I need to be fasting for the exam?
Fasting is generally not required. However, ask the clinic when scheduling, especially if you have underlying conditions or are taking medications.
3. What if I don’t have vaccination records?
The civil surgeon may order blood tests to check immunity or simply administer the required vaccines again. Missing records won’t disqualify you but may lead to extra costs or appointments.
4. Can I use a regular doctor instead of a USCIS civil surgeon?
No. Only a USCIS-approved civil surgeon (for applicants in the U.S.) or panel physician (for consular cases abroad) can conduct valid immigration medical exams.
5. How long are the exam results valid?
Form I-693 is valid for up to two years from the date the civil surgeon signs it, as long as it is submitted to USCIS within 60 days of the signature.
You can find a USCIS-approved doctor near you using the official tool at https://my.uscis.gov/findadoctor.
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