The immigration medical examination, formally known as Form I-693, is a required health assessment for applicants seeking to become lawful permanent residents (green card holders). You complete it by scheduling an appointment with a USCIS-designated civil surgeon, who performs a medical evaluation and provides sealed results for you to submit with your Form I-485 application. The exam includes medical history review, physical examination, mental status evaluation, and diagnostic tests to determine whether you have health conditions that affect your admissibility to the United States.
Table of Contents
- Finding a USCIS-Designated Civil Surgeon
- What Happens During the Medical Examination
- Vaccination Requirements
- Submitting Your Exam Results and Validity
- Cost and Payment Expectations
- Frequently Asked Questions
Finding a USCIS-Designated Civil Surgeon
only a USCIS-designated civil surgeon can perform your immigration medical exam; you cannot use your regular doctor or urgent care provider. You can locate a civil surgeon using USCIS's online tool, which allows you to search by address, city, state, or ZIP code. Call ahead to confirm the surgeon accepts immigration medical exams, can perform any tests you need, and has availability within your timeline.
What Happens During the Medical Examination
Your civil surgeon will conduct a comprehensive health evaluation that includes medical history review, physical examination, mental status evaluation, and diagnostic tests. The results determine whether you have Class A conditions (rendering you inadmissible) or Class B conditions (serious or permanent health issues that don't make you inadmissible). For example, only Class A tuberculosis—clinically active and communicable TB—renders an applicant inadmissible. If you have a positive TB test but no active disease, you receive a Class B classification and may still adjust status to become a green card holder.
Vaccination Requirements
You must document age-appropriate vaccines, including measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, hepatitis B, varicella, influenza, pneumococcal disease, and meningococcal disease. You only need one dose of each vaccine at the exam, not a complete series. COVID-19 vaccination is no longer required as of March 11, 2025. You can obtain vaccines from a private healthcare provider and bring written vaccination documentation to your appointment, so you don't have to get them all from the civil surgeon.
Submitting Your Exam Results and Validity
After your exam, the civil surgeon places the completed Form I-693 in a sealed envelope, which you then submit with your Form I-485. USCIS may reject your I-485 if the I-693 is missing. The validity period depends on when the form was signed. Form I-693 signed on or after November 1, 2023, does not expire and retains evidentiary value indefinitely. Forms signed before that date remain valid for 2 years from the signature date.
Cost and Payment Expectations
USCIS does not regulate civil surgeon fees, which vary significantly by location. You must pay all costs directly to the civil surgeon, including the exam fee, any follow-up tests, and any needed treatment. Insurance may not cover portions of the immigration medical examination. Before scheduling, ask the surgeon about their total fee and what it includes—some charge separately for the exam, diagnostic tests, and vaccines. This helps you budget and avoid surprises.
Frequently Asked Questions
Can I use my regular doctor or primary care provider for the immigration medical exam?
No. Only a USCIS-designated civil surgeon can perform the immigration medical examination. Use the Find a Civil Surgeon tool to locate an authorized provider.
What if I test positive for tuberculosis during the exam?
Only Class A tuberculosis—clinically active and communicable TB—makes you inadmissible. A positive TB test without active disease results in a Class B classification, and you can still adjust status.
What if I'm missing some required vaccinations?
You can obtain vaccines from a private healthcare provider and bring written vaccination documentation to your appointment. You only need one dose of each required vaccine at the exam, not a complete series.