Understanding the Immigration Medical Exam
The immigration medical exam is a mandatory step for almost all applicants seeking lawful permanent residence in the United States. Required by U.S. immigration law, its purpose is to confirm that no applicant has a health condition that poses a threat to public safety or would place an undue burden on the healthcare system.
The exam includes a review of your medical and immunization history, a physical and mental evaluation, screening for drug and alcohol abuse, and tests for communicable diseases like tuberculosis. As of December 2, 2024, USCIS requires Form I-693 (the medical exam results) to be submitted at the same time as your green card application (Form I-485); missing this step can lead to rejection.
Who Performs the Exam and What to Bring
The immigration medical exam must be conducted by a government-authorized physician. Within the United States, this is a USCIS-designated civil surgeon; for applicants abroad, a panel physician approved by the U.S. embassy or consulate performs the exam. To locate a civil surgeon in the U.S., use the USCIS Find a Doctor tool or call the USCIS Contact Center at 1-800-375-5283.
At Jana HealthCare, our board-certified physicians are experienced in conducting these exams with precision and patient-centered care, ensuring your paperwork is handled accurately and compassionately. The exam is a self-pay service and is not covered by insurance; the cost typically ranges from $350 to $700 depending on the provider and location.
Bring a valid government-issued photo ID, complete vaccination records, your medical history including a list of medications, any prior chest X-rays, and a letter from your regular doctor about ongoing health issues. U.S.-based applicants must also bring Form I-693 (complete Part 1 only — do not sign until instructed by the civil surgeon). Applicants from abroad must bring their green card interview appointment letter from the National Visa Center.
What Happens During the Exam
The immigration medical exam typically takes 30 to 60 minutes and is conducted by a USCIS-designated civil surgeon. The appointment begins with a thorough review of your medical history and immunization records, followed by a physical checkup that examines the eyes, ears, nose, throat, heart, lungs, lymph nodes, and skin. The civil surgeon also conducts a brief mental health assessment.
Required Tests and Screenings
Screening for communicable diseases is a core part of the exam. For tuberculosis testing, applicants aged 2 and older in the U.S. receive a blood test known as the interferon gamma release assay (IGRA). Applicants abroad aged 15 and older in high-burden countries typically undergo a chest X-ray. All applicants aged 15 and older must also provide a blood sample for syphilis testing and a urine sample for gonorrhea screening.
The civil surgeon will ask about your prescription medications and any past or current drug and alcohol use. You do not need to worry about minor, well-managed health issues — conditions like controlled hypertension or diabetes, or a history of successfully treated infections, are not grounds for denial.
Vaccination Record Review
The civil surgeon verifies your vaccination records against the CDC’s Advisory Committee on Immunization Practices (ACIP) guidelines. If any age-appropriate vaccines are missing, they can be administered during the exam. The goal is to ensure complete documentation before your immigration application is submitted.
Vaccination Requirements and Validity
Vaccination verification is a central part of the immigration medical exam. The civil surgeon reviews your immunization history against the current guidelines from the CDC's Advisory Committee on Immunization Practices (ACIP). Required vaccines typically include those for measles, mumps, rubella (MMR), polio, tetanus, diphtheria, pertussis (Tdap), hepatitis A and B, varicella (chickenpox), influenza, and pneumococcal pneumonia. The exact list depends on your age, so it is important to bring complete vaccination records to your appointment.
In a significant update, USCIS has eliminated the COVID-19 vaccination requirement from Form I-693. If you are missing any required vaccines, the civil surgeon can administer them during the exam or refer you to a health department or your family physician. At janahealthcare.com, the civil surgeon can review your records and help you complete any missing shots so that you meet the vaccination requirements without unnecessary delays.
Validity Period of Form I-693
For forms signed on or after November 1, 2023, the completed Form I-693 is generally valid for two years from the date the civil surgeon signs it. The exam must remain valid through the date you file your green card application; if it expires before you submit your paperwork, you may need a new exam. The completed form is placed in a sealed envelope that the applicant must not open. Tampering with the seal invalidates the form and can result in delays or rejection of your application, so handle it carefully.
Conditions That Can Affect Admissibility
The immigration medical exam is designed to identify health conditions that could render an applicant inadmissible to the United States. Knowing which conditions fall into this category helps you prepare and avoid surprises.
Under U.S. immigration law, the primary grounds for denial on medical grounds include active, untreated communicable diseases of public health significance, such as tuberculosis, syphilis, gonorrhea, and leprosy. A history of drug or alcohol abuse, mental illness associated with harmful behavior, and an inability to support oneself financially (the "public charge" ground) can also affect admissibility. The civil surgeon performing the exam will check for these conditions and report any findings to USCIS.
Well-managed chronic conditions, such as diabetes, hypertension, or HIV, generally do not disqualify an applicant. A previously cured communicable disease is not a barrier as long as treatment records are available. What matters is that the condition is currently under control or has been successfully resolved.
How to Handle a Condition Found During the Exam
If the civil surgeon identifies a condition that could affect admissibility, the next step may be to apply for a waiver of inadmissibility. USCIS consults with the CDC during the waiver process and may attach conditions, such as agreeing to undergo treatment upon entry into the U.S.
To prevent or challenge a denial, bring proof of successful treatment for past infectious diseases, documentation of addiction treatment or mental health management, and a doctor's letter explaining how any serious condition is under control. Applicants visiting a multidisciplinary practice like Jana HealthCare can benefit from a coordinated approach—the civil surgeon reviews records and answers questions, while the clinic's broader medical team can help gather supporting documentation for any ongoing health needs.
Understanding these potential barriers ahead of time and coming prepared with the right paperwork makes the exam process smoother and increases the likelihood of a favorable outcome.
After the Exam: Sealed Results and Submission
Once the civil surgeon completes the physical exam, required tests, and vaccine review, they fill out Form I-693 and the vaccination record. The documents are then placed in a sealed envelope. The applicant is instructed not to open the envelope, as tampering invalidates the form and may require a new exam.
For applicants applying from within the United States, the sealed envelope must be submitted at the same time as the green card application, Form I-485. It can be mailed directly to USCIS or brought to the interview. For applicants abroad, the sealed envelope is brought to the visa interview, though in some cases the panel physician sends the results directly to the U.S. embassy or consulate.
Women must complete the exam even during menstruation. Pregnant women may postpone required chest X-rays until after giving birth, but must complete them before entering the U.S. or before Form I-485 is finalized.
If the exam reveals a condition that needs treatment or follow-up, such as a positive TB test or incomplete vaccinations, the applicant may need additional visits before the civil surgeon can finalize Form I-693. At janahealthcare.com, the civil surgeon explains each step clearly and can coordinate any follow-up care needed, making the process more straightforward for Brooklyn applicants.
The sealed results are valid for a specific period. For most applicants, the Form I-693 is good for two years from the date the civil surgeon signed it. After receiving the sealed envelope, keep it safe and submit it according to USCIS guidelines to avoid delays.
Preparing for a Smooth Immigration Medical Exam
The physician who completes your immigration medical exam isn't just any doctor. USCIS requires that the exam be performed by a civil surgeon, a physician specifically designated by the agency to conduct the required medical evaluation and complete Form I-693. While any licensed doctor might perform routine checkups, only a civil surgeon's findings can be considered in your green card application. Choosing the right one affects not only your experience but also the accuracy and completeness of your medical record.
What a Civil Surgeon Does
A civil surgeon reviews your medical history, performs a physical exam, checks your vaccination records against current USCIS requirements, and screens for communicable diseases. They also complete and sign the medical examination report that becomes part of your file. This is the same role many refer to when they search for a clinic "near me" that handles immigration physicals.
At Jana HealthCare, you work directly with a designated civil surgeon who explains each step in plain language. The process includes a thorough review of your medical history, discussion of your vaccination status, and necessary lab work, all while keeping your appointment efficient and stress-free.
How to Find a Qualified Civil Surgeon
The best place to start is the USCIS designated civil surgeons page, which lists approved physicians by state. However, not all civil surgeons offer the same level of convenience or patient-centered care. Some charge extra for forms, have long wait times, or rush through the exam. Before you schedule, ask about their experience with Form I-693, their familiarity with current vaccination schedules, and whether they explain the results and next steps. A good match will make you feel informed and at ease, not like another number in a queue.
