What is immigration medical exam
When you apply for adjustment of status by filing Form I-485, you typically must undergo a USCIS immigration medical exam to prove you meet health requirements. This examination, performed by a USCIS-designated civil surgeon, evaluates your overall health and ensures you have received or are eligible for vaccinations against vaccine-preventable diseases. Whether you’re a prospective immigrant or an employer coordinating health compliance, understanding this process is essential for a smooth application.
Purpose and requirements
The immigration medical exam serves two main goals:
- Identify inadmissible health conditions, such as Class A tuberculosis or certain communicable diseases
- Verify vaccination status against diseases like MMR, varicella, and polio
Civil surgeons follow the CDC’s Technical Instructions for Civil Surgeons and HHS guidelines when conducting the exam [1]. You must show you’ve met each requirement or qualify for a waiver.
Who must undergo the exam
You need this exam if you are:
- Filing Form I-485 (adjustment of status) in the United States
- Applying for an immigrant visa through consular processing (exam overseas by a panel physician)
- Seeking an immigration medical evaluation to support a green card or citizenship application
Employers arranging group processing for employees can bundle exams at an immigration medical evaluation clinic to streamline scheduling.
Find a civil surgeon
Using the USCIS locator
To locate a USCIS-designated civil surgeon in the U.S., visit the myUSCIS Find a Civil Surgeon page. You’ll search by ZIP code or city to find authorized doctors in your area [2].
Checking availability and fees
USCIS does not regulate civil surgeon fees. Before booking, call multiple locations to:
- Compare exam fees
- Ask if they accept insurance
- Confirm appointment availability
Prices vary widely, so this step helps manage costs and avoid surprises.
Prepare for your appointment
Completing Form I-693 correctly
Form I-693, Report of Immigration Medical Examination and Vaccination Record, must be filled out accurately:
- Print the most recent edition from USCIS
- Complete Part 1 but do not sign it until the civil surgeon instructs you
- Bring any existing vaccination records or medical history
Missing or incomplete fields can delay your adjustment of status application.
Gathering medical records and immunizations
Collect documents that prove previous vaccinations or medical tests:
- Childhood immunization records
- Tuberculosis tests or chest X-rays
- Records of waiver-eligible conditions (eg, pregnancy or immunocompromised status)
Having these on hand speeds up the exam and ensures the surgeon records all necessary data.
Undergo the medical examination
Physical examination components
During the exam, the civil surgeon will:
- Take your height, weight, blood pressure and temperature
- Examine your eyes, ears, nose, throat, lungs, heart and abdomen
- Check for signs of communicable diseases such as syphilis and gonorrhea
If the panel physician abroad finds a Class A medical condition, you may need a second exam in the U.S. by a civil surgeon [3].
Vaccination assessment and administration
Civil surgeons compare your records to CDC vaccination requirements:
- Measles, mumps and rubella (MMR)
- Varicella
- Polio
- Tdap (tetanus, diphtheria, pertussis)
- Influenza, if seasonally recommended
Missing vaccines will be administered on site or referred. The CDC evaluates new vaccines periodically to update requirements [1].
Pregnancy and medical waivers
If you’re pregnant or immunocompromised, you may delay certain vaccines. Civil surgeons can issue a blanket waiver for vaccines deemed “not medically appropriate” without a separate RFE [4]. Note that delaying vaccines can extend your application’s processing time.
After the exam
Sealed Form I-693 submission
Once the exam is complete, the civil surgeon will:
- Sign and seal Form I-693 and any supporting documents in an envelope
- Instruct you not to break or open the seal
USCIS will reject opened or altered envelopes. You’re responsible for submitting the sealed envelope with your Form I-485, typically by mail or online per application instructions [3].
Tracking your form and next steps
After submission:
- Keep a copy of the sealed envelope and shipping receipt
- Monitor your case status on USCIS.gov
- Respond promptly if USCIS issues a Request for Evidence
Timely follow-up avoids unnecessary delays in your immigration process.
Manage exam costs
Fee comparison and insurance coverage
Since civil surgeons set their own fees, shop around:
- Ask about exam, laboratory, X-ray and vaccination costs
- Inquire whether your insurance plan covers any portion
- Explore cash-pay discounts or employer group rates
Bundling exams with other services like dot physicals for commercial drivers can sometimes yield savings.
Typical fee ranges
| Service component | Cost range |
|---|---|
| Medical examination | $100–$200 |
| Chest X-ray | $50–$100 |
| Blood tests (if required) | $50–$150 |
| Vaccinations | $20–$150 per shot |
Keep receipts for potential reimbursement or tax documentation.
Avoid common mistakes
Form errors and seal integrity
Frequent pitfalls include:
- Signing Part 1 of Form I-693 prematurely
- Illegible or incomplete entries
- Breaking the seal on the completed form
Double-check the form with your civil surgeon before leaving the clinic.
Missed vaccinations and waivers
Ensure the surgeon:
- Reviews prior vaccine records thoroughly
- Administers or waives all required vaccines
- Documents any blanket waivers for medical reasons
Missing vaccines can trigger an RFE and prolong your application.
Integrate with other compliance exams
Linking with workplace health exams
If your organization schedules multiple regulatory exams, coordinate:
- USCIS immigration medical exam
- commercial driver physicals
- respirator medical clearance exam
- faa medical certification exam
Bundling appointments at a certified occupational exam clinic reduces downtime for employees.
Related certification services
Employers managing compliance can also explore:
This holistic approach simplifies record-keeping and audit preparedness.
Frequently asked questions
Can you reuse a prior exam
You may not repeat the entire exam if you already completed it overseas, but you’ll need:
- A follow-up immunization assessment by a U.S. civil surgeon
- Verification of prior Class A condition resolution
Review Form I-693 Instructions to confirm eligibility.
What if exam is rejected
USCIS will issue a rejection notice if:
- The envelope seal is broken or altered
- You missed required vaccines
- The form is outdated or incomplete
Respond by correcting the issue and submitting a new sealed envelope promptly.
How long is exam valid
Form I-693 is generally valid for two years from the civil surgeon’s signature date. Check USCIS guidance before relying on an existing exam.
Conclusion
Navigating the USCIS immigration medical exam process can seem complex, but with proper preparation you can avoid common delays. Start by finding a qualified civil surgeon, complete Form I-693 accurately, gather all medical and vaccination records, and budget for exam fees. By treating this exam as you would other regulatory health assessments—such as respirator clearance test asheville or dot medical exam clinic—you ensure compliance, protect your application timeline and maintain workplace health standards.