What to Expect at an Immigration Medical Exam?

As a Green Card applicant, you must have a medical exam as part of the permanent residency process.  This medical exam is used to establish that you don’t have any health conditions that would make you inadmissible to the United States and that all of your vaccinations are up to date. You will be screened for conditions such as tuberculosis, syphilis, gonorrhea, Hansen’s disease (leprosy), substance abuse, and mental disorders.

1.  Find a doctor to perform an immigration medical exam

2.  Cost and documents to bring at an immigration medical exam

3.  Medical history records and vaccinations

4.  Receive and submit the sealed medical exam report properly

5.  What if there is a health issue

Immigration Medical Exam

1. Find a doctor to perform an immigration medical exam

If you are adjusting your status inside the United States, you can submit a Form I-693, Report of Medical Examination and Vaccination Record medical exam either at the same time you submit your Form I-485, or at your Green Card interview. You will need to find a qualified doctor to perform the exam. The United States Citizenship and Immigration Services (USCIS) has a list of designated civil surgeons who are authorized to perform the exam. The USCIS website has a search feature that allows you to search by address or zip code. Click here to find an authorized civil surgeon near you. Most cities will have at least one civil surgeon and larger metro areas usually have quite a few to choose from. You might have to travel some distance if you live in a small town or rural area.
If you are not already in the United States, you will schedule your exam after your interview at the U.S. consulate is scheduled. You must complete the exam before the interview date. The exam must be performed by a doctor, known as a panel physician, approved by the U.S. embassy in that country. This list, along with specific instructions, varies consulate by consulate.  Therefore, it is important to review the instructions particular to that consulate. Click here to find the U.S. consulate for its interview instructions.

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2. Cost and documents to bring at an immigration medical exam

You might want to call several civil surgeons or panel physicians on the list if you have multiple choices available because exam costs and appointment availability can vary. Exam costs in the U.S. typically run about $200 to $500 per person. Neither USCIS nor U.S. consulates charge for the exam but doctors performing the exam do. Depending on the doctor, appointments need to be scheduled anywhere from a couple of days to several weeks ahead of time. Some doctors only perform exams at certain set times while others are more flexible.

When you schedule your appointment, you will be typically given a list of what you should bring with you to your appointment. You should expect to bring your passport or other form of identification.  Previous medical and vaccination records aren’t absolutely necessary, but bringing them can save you time and money. Otherwise, you will likely have to repeat shots and tests that you have previously received. Some civil surgeons will expect you to bring your own interpreter if you do not speak enough English to communicate effectively.

Most doctors will have I-693 forms on hand, though some may ask you to bring that as well. You will need to fill out the first part, which asks for basic information such as your name, contact details and basic biographical information. The doctor will complete the medical exam portion of the form. You will be screened for the medical conditions previously mentioned. You will then have to sign the form in the presence of the doctor once it is complete.

3. Medical history records and vaccinations

Having copies of current medical records can cut down on the number of tests that have to be administered. For example, if you have proof of a recent negative TB test you will not have to have another one. It will also reduce your exam costs if you don’t have to have certain tests. Likewise, a current vaccination record will keep you from having to be re-vaccinated. 

The required vaccines are ones most people typically receive as children, such as measles, tetanus, polio, and hepatitis A/B. Therefore, you will likely need few vaccines if you have up-to-date records, though you may need boosters. The flu shot, are only required seasonally and you will also not need to receive vaccines that aren’t appropriate for your age group. You won’t be required to have the chicken pox vaccine if you can verbally confirm that you either previously had the disease or the vaccine, but you are expected to produce vaccine records or antibody tests if you wish to avoid other vaccines.

You sometimes will be required to return for a follow-up visit for the second dose of a vaccine or to see if you have a reaction to the TB test. Additionally, if you are found to have one of the conditions you were screened for, you will have to be successfully treated for it before the doctor can sign the exam form. Even without additional tests and vaccines, it can take several days before the form is completed and ready to be picked up.

4. Receive and submit the sealed medical exam report properly

Once complete, you should receive two envelopes from the doctor. The first is your personal copy of the exam results and any additional required documentation such as vaccine records. The second envelope should contain the same documents, but the envelope will be sealed and marked with the words “DO NOT OPEN, FOR USCIS USE ONLY” or similar words. USCIS or U.S. consulate will not accept envelopes with broken seals.

If you are interviewing for your Green Card at a U.S. consulate you should bring your sealed exam report with you to the interview. The medical report is good for six months only.

If you are adjusting your status in the U.S., once your medical exam is complete, it must be submitted within 60 days and is valid for a two-year period. You can either submit it with your adjustment of status application or at your Green Card interview. There are advantages and disadvantages to both options. 

If you submit your medical exam at the same time as your adjustment of status application there is a chance that more than two years will pass from the time of your exam until your interview date, requiring you to repeat the exam. Therefore, many Green Card applicants prefer to wait until they receive their interview notice, which is typically sent 5-7 weeks before the interview. While this may be plenty of time to complete the medical exam, you could find yourself in a time crunch if it takes you several weeks to get an appointment with a civil surgeon or you need follow-up treatment, tests or vaccines. You should consider whether you are likely to need follow-up visits, the typical time needed to schedule an exam in your geographic area and the adjustment of status processing times for your visa type and local USCIS office before making that determination.

5. What if there is a health issue

Most applicants don’t have major issues with their medical exam results. But if you are found to have a disqualifying condition that can’t be treated, you will be considered inadmissible to the U.S. and will not qualify for a Green Card. Any of the following health-related problems will cause your green card application gets denied:

  • Communicable Diseases: gonorrhea, infectious leprosy, infectious stage syphilis, or active tuberculosis.
  • Current physical or mental disorders, with associated harmful behavior; or past physical or mental disorders, with associated harmful behavior that is likely to recur or lead to other harmful behavior.
  • Drug abuse or drug addiction

However, there is a process to request a waiver. It is not easy to have a waiver granted by USCIS.  As such, if you believe you may have a disqualifying condition, you should consider seeking treatment for it before it is time to have your medical exam. Most applicants can avoid issues by anticipating the time and expense involved and obtaining their medical records beforehand. If your health-related issue is complex and you are uncertain whether it will jeopardize your green card, you can always consult an experienced immigration attorney to help you figure out.  

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