The USCIS immigration physical is a mandatory medical examination for individuals seeking to adjust their status to lawful permanent resident or applying for certain visas. This exam ensures applicants do not have health conditions that could make them inadmissible under U.S. immigration law. Only a civil surgeon designated by USCIS can perform this examination and complete the required Form I-693.
Proper preparation for the immigration physical includes bringing valid identification, official vaccination records, relevant medical history documents, and a list of current medications to the appointment. Many applicants feel uncertain about what this process involves and how to ensure they meet all requirements. Understanding what happens during the exam and what documentation is necessary helps avoid delays and complications.
This guide covers the essential documents needed, the step-by-step examination process, and what to do after the appointment is complete. Applicants will learn how to locate an authorized civil surgeon, what medical tests and screenings to expect, and how to properly submit their sealed medical examination results to USCIS.
Key Documents and Items to Bring
Bringing the correct documentation to your immigration physical ensures the examination proceeds smoothly and meets USCIS requirements. Applicants should prepare four essential categories of documents: valid identification, vaccination records, medical history information, and the official USCIS medical examination form.
Valid Government-Issued Identification
A government-issued ID is mandatory for confirming identity during the immigration physical. Acceptable forms include a passport, driver’s license, or state-issued identification card.
The identification must be current and unexpired. A passport serves as the most universally accepted form of identification, particularly for applicants who have recently arrived in the United States. For those who have been residing in the country, a driver’s license or state ID card is equally acceptable.
Applicants should ensure the name on their identification matches the name on their immigration application exactly. Any discrepancies can cause delays in processing. If the document shows a previous name due to marriage or legal name change, bring supporting documentation such as a marriage certificate or court order.
Required Vaccination Records
Vaccination records document immunization history and help the physician determine which vaccines are needed to meet USCIS standards. Applicants should bring any available vaccination documentation from their country of origin or previous medical providers.
The USCIS requires specific vaccines based on age and medical history. These typically include MMR (measles, mumps, rubella), tetanus-diphtheria-pertussis, polio, hepatitis A and B, influenza, varicella (chickenpox), and pneumococcal vaccines. The examining physician reviews existing records to identify any gaps.
Missing vaccines can be administered during the immigration physical appointment at facilities equipped to provide them. If records are unavailable, blood tests can sometimes confirm immunity to certain diseases. Applicants who received vaccines abroad should attempt to obtain translated records before the appointment, though translation is not always required if the physician can interpret the documentation.
Medical History Documentation
Medical history documentation provides the examining physician with necessary background information about past and current health conditions. This includes records of previous surgeries, chronic illnesses, ongoing treatments, and any medications currently being taken.
Applicants should prepare a written list of current medications with dosages and frequency. Information about mental health treatment, hospitalizations, and significant injuries should also be included. If medical records are in a language other than English, bringing translated versions can expedite the examination process.
Previous test results related to tuberculosis or other communicable diseases can be helpful if recent. The physician needs to understand any ongoing medical management to complete Form I-693 accurately. Honest disclosure of medical history is necessary, as incomplete information can lead to complications in the immigration process.
Form I-693 Preparation
Form I-693, the Report of Medical Examination and Vaccination Record, is the official USCIS document that the authorized civil surgeon completes during the immigration physical. Applicants can download this form from the USCIS website before their appointment, though many physicians provide it at the time of the examination.
The form should not be filled out by the applicant. Only physicians designated as civil surgeons by USCIS have the authority to complete and sign Form I-693. The examining physician fills out the form based on the physical examination findings, test results, and vaccination status.
After completion, the physician seals the form in an envelope. This envelope must remain sealed and unopened by the applicant. Opening the sealed envelope invalidates the examination results, requiring a new physical. The sealed form is submitted directly to USCIS along with other required immigration documents. Form I-693 results remain valid for two years from the date of the physician’s signature.
Understanding the Immigration Physical Process
The immigration medical exam serves as a health screening requirement for green card and visa applicants, conducted exclusively by USCIS-approved civil surgeons. Applicants must understand how to find an authorized physician and what to prepare before their appointment.
Purpose of the Immigration Medical Exam
The immigration physical exam protects public health by screening applicants for specific medical conditions that could affect their admissibility to the United States. U.S. Citizenship and Immigration Services requires this examination to identify four main health-related concerns: communicable diseases of public health significance, failure to show proof of required vaccinations, physical or mental disorders with associated harmful behavior, and drug abuse or addiction.
The exam differs from a standard physical. The civil surgeon evaluates only conditions specified by the U.S. Public Health Service for immigration purposes.
The examination does not replace comprehensive medical care. The authorized physician is not required to diagnose or treat conditions beyond those relevant to immigration law.
Selecting a USCIS-Approved Civil Surgeon
Applicants adjusting status within the United States must complete their immigration physical with a designated civil surgeon. These physicians have been specifically authorized by USCIS to perform immigration medical examinations and complete Form I-693.
The official USCIS website maintains a searchable directory of approved civil surgeons organized by location. Applicants cannot use regular doctors or general practitioners for this examination. The civil surgeon designation is required.
When selecting a provider, applicants should verify current authorization status and confirm the physician can complete all required components. Some civil surgeons, such as those at LocalMD in New York City, offer streamlined services specifically designed for immigration physicals.
Fees vary by provider and location. Applicants should contact civil surgeons directly to inquire about costs before scheduling.
Scheduling and Preparing for Your Appointment
USCIS requires Form I-693 to be submitted with the Form I-485 adjustment of status application. Applicants cannot mail medical exam results separately after submission.
Immigration medical exam results completed and signed by a civil surgeon on or after November 1, 2023, do not expire and remain valid indefinitely while the I-485 application is pending. Results become invalid if the associated application is withdrawn or denied.
Applicants should bring specific documentation to their appointment:
- Valid passport or government-issued photo identification
- Immunization and vaccination records
- List of current medications
- Tuberculosis clearance certificate (if previously tested positive)
- Syphilis treatment documentation (if applicable)
- Mental health or substance abuse treatment records (if applicable)
The civil surgeon will provide the blank Form I-693 at the appointment.
What to Expect During Your Immigration Physical
The immigration medical examination follows a structured process that includes reviewing your health history, performing a standard physical exam, checking vaccination records, and completing official documentation. A USCIS-designated civil surgeon conducts each component to verify that applicants meet health requirements for immigration.
Medical History Review
The civil surgeon begins by collecting detailed information about your past and current health conditions. You will answer questions about previous illnesses, surgeries, hospitalizations, and any ongoing medical treatments or medications.
The medical history review also covers mental health, including any history of substance abuse or psychological conditions. This information helps the civil surgeon assess whether any health issues require additional documentation or follow-up testing.
Be prepared to discuss communicable diseases, chronic conditions, and any medical treatments received in other countries. Providing accurate and complete information during this phase ensures the examination proceeds smoothly and prevents delays in processing Form I-693.
Physical Examination Procedures
The civil surgeon performs a comprehensive physical assessment of major body systems. This examination includes checking your heart, lungs, abdomen, lymph nodes, and extremities for any signs of disease or abnormality.
The physician will measure your height, weight, blood pressure, and pulse. They will examine your eyes, ears, nose, throat, and skin to identify any visible health concerns.
A tuberculosis screening is mandatory for all applicants. The civil surgeon administers either a tuberculin skin test or an interferon-gamma release assay blood test. If results indicate TB infection, a chest X-ray becomes necessary to determine whether the infection is active.
Blood and urine tests screen for syphilis and gonorrhea in applicants aged 15 and older. These laboratory tests are standard requirements for the immigration medical examination and typically take a few days to process.
Vaccination and Immunization Review
The civil surgeon evaluates your immunization records against the vaccine schedule required by the Centers for Disease Control and Prevention. Required vaccinations typically include MMR, Tdap, hepatitis A and B, influenza, varicella, and polio.
If you lack documentation of certain vaccines, the civil surgeon can administer missing immunizations during your appointment. At facilities like LocalMD, authorized civil surgeons provide on-site vaccinations to complete this requirement efficiently.
Age-specific vaccine requirements apply, so not all applicants need the same immunizations. Applicants who have medical contraindications or religious objections to certain vaccines may qualify for waivers, which the civil surgeon can document appropriately.
Completion and Submission of Required Forms
After completing all examination components, the civil surgeon fills out Form I-693, Report of Medical Examination and Vaccination Record. This official document summarizes your health status and confirms whether you meet immigration medical requirements.
The civil surgeon places the completed Form I-693 in a sealed envelope and signs across the seal. You must not open this envelope, as USCIS will reject opened forms.
You receive the sealed envelope to submit with your immigration application or bring to your adjustment of status interview. Some applicants keep the sealed form for up to 60 days before submission, though validity periods may vary based on USCIS requirements.
After the Exam: Next Steps and Important Tips
Once the civil surgeon completes the immigration physical, applicants receive sealed medical documents and Form I-693 that must be handled properly to avoid delays or rejection. Understanding validity periods and addressing any deficiencies promptly ensures the application process moves forward smoothly.
Receiving and Handling Your Sealed Report
The civil surgeon provides the medical examination results in a sealed envelope along with completed Form I-693. Applicants must never open this sealed envelope, as doing so invalidates the entire examination and requires starting the process over at additional cost.
The sealed package contains the Report of Medical Examination and Vaccination Record, which documents all findings from the physical exam, laboratory tests, and vaccination status. Some civil surgeons may provide applicants with a copy of their vaccination records separately for personal records, but the official sealed documents remain untouched.
Applicants should inspect the exterior of the sealed envelope to verify the civil surgeon properly signed across the seal and included the date. The envelope must show no signs of tampering when submitted to USCIS. Store the sealed documents in a safe, dry location until submission or the scheduled interview date.
Form I-693 Validity and Submission Guidelines
Form I-693 remains valid for two years from the date the civil surgeon signs it, but only if submitted to USCIS within 60 days of the signature date. If more than 60 days pass before submission, applicants must return to the civil surgeon for a new signature, though a complete re-examination may not be necessary depending on how much time has elapsed.
USCIS accepts Form I-693 in three ways:
- Submitted with the initial adjustment of status application
- Brought to the green card interview in the sealed envelope
- Mailed in response to a Request for Evidence from USCIS
Submitting the form with the initial application often speeds up processing since USCIS has all required documentation from the start. However, timing the exam correctly is crucial because the two-year validity period begins when the civil surgeon signs, not when USCIS receives it.
Addressing Missing Documentation or Vaccines
If vaccination records are incomplete during the exam, the civil surgeon notes the deficiency on Form I-693. Applicants must complete any missing required vaccines and return to the same civil surgeon for documentation updates before USCIS will approve the medical examination.
The civil surgeon provides a supplemental vaccination worksheet listing which immunizations need completion. Applicants should obtain these vaccines from their primary care physician or the civil surgeon’s office, then schedule a follow-up appointment to update the records. Some offices, such as LocalMD, offer both the initial examination and follow-up vaccination services to streamline the process.
USCIS may issue a Request for Evidence if medical documentation is incomplete when the application reaches review. Responding promptly with updated vaccination records or medical information prevents application delays or denials. Applicants should maintain contact information for their civil surgeon in case questions arise during USCIS processing.
Frequently Asked Questions
Understanding the documentation requirements, preparation steps, medical testing procedures, designated physician locations, validity timelines, and associated costs helps applicants navigate the USCIS immigration physical with confidence.
What documents are required for a USCIS immigration physical examination?
Applicants must bring a valid government-issued photo ID (passport or driver’s license), vaccination records if available, and the completed I-693 form with demographic information filled out on the first two pages and name plus A-number at the top of each page.
How should one prepare for an immigration physical examination?
Applicants should download and fill out the I-693 form using Adobe PDF Reader with black ink or typed text in capital letters, gather any available vaccination records, and bring a photo ID to the appointment without signing or dating the form beforehand.
What medical tests can be expected during the USCIS medical exam?
The examination includes a physical assessment, medical and social history review, immunization record evaluation, blood tests, and urine tests that must be performed during or after the appointment rather than beforehand.
Where can I find a designated USCIS civil surgeon for my immigration physical?
Applicants can locate USCIS-designated civil surgeons through the official USCIS website’s search tool or by contacting clinics like LocalMD in New York City that specialize in immigration medical examinations with certified civil surgeons on staff.
How long is the validity period of the I-693 medical exam results?
Applicants must pick up their completed sealed I-693 form within 30 days of the medical examination date and submit it to USCIS or their immigration attorney to ensure the results remain valid for processing.
What are the costs associated with the USCIS immigration physical examination?
The medical examination and I-693 form completion typically costs between $200 and $410, while laboratory tests range from $130 to $220 depending on age and medical history, and vaccinations are often covered by insurance when obtained at pharmacies.
