When applying for a Green Card (Adjustment of Status) in the United States, U.S. Citizenship and Immigration Services (USCIS) requires a medical examination to establish that Applicants who are seeking immigration benefits are not inadmissible to the United States on public health grounds.
The results of a medical examination are confidential, and USCIS uses them primarily for immigration purposes.
Medical Examination Form
Form I-693 (Report of Medical Examination and Vaccination Record) is the form used to report the results of a medical examination to USCIS.
Finding a Doctor
The medical examination must be done by a doctor who is authorized by USCIS. USCIS designates certain doctors (also known as civil surgeons) to perform the medical exam required for most Applicants. Military physicians are also authorized to perform immigration medical exams at a military treatment facility within the United States for U.S. veterans, members of the U.S. military and designated dependents.
To find a designated civil surgeon in your area, visit the USCIS website Find a Doctor page and enter your address or zip code.
Form I-693 must be dated no earlier than 60 days before you filed your adjustment of status application. A properly and timely completed Form I-693 remains valid for two years from the date of the civil surgeon’s signature.
The Applicant must pay all costs of the medical examination, including the cost of any follow-up tests or treatment that is required.
Each Applicant must submit a separate Form I-693. There is no government filing fee for the medical exam, but the doctor will charge to perform and complete the medical exam form. It is a good idea to call a few doctors to find out how much they charge for the exam since prices can vary by a few hundred dollars. You can also check with the doctor’s office to see if they accept the Applicant’s medical insurance plan; that way the Applicant may not have to pay everything out of pocket.
What to Bring to the Exam
- A valid government-issued form of photo identification (for example, your unexpired passport or driver’s license, unexpired consular identification card, employment authorization document, etc.).
- If the Applicant is under 14 years of age, acceptable documents for proof of identity must show his or her name, date and place of birth, parents’ full names, and any other identifying information about the Applicant. Acceptable documents include birth certificates (with an English translation, if necessary).
- Immunization or vaccination record.
- If the Applicant has any current health problems, a letter from the Applicant’s regular doctor regarding diagnosis, prognosis, and any treatment plan(s).
- Payment (check with the doctor’s office to see what are acceptable forms of payment)
- Health insurance card, if any (check with the doctor’s office to make sure the office accepts the Applicant’s medical insurance plan).
All Applicants for adjustment of status must present documents showing they were vaccinated against a broad range of vaccine-preventable diseases. The civil surgeon will review the Applicant’s vaccination history with the Applicant to determine whether he or she has had all the following required vaccinations:
- Tetanus and Diphtheria Toxoids
- Haemophilus influenzae type B
- Hepatitis B
If the Applicant never received certain vaccines or is unable to prove he or she received them, the civil surgeon can provide them at an extra cost. The Applicants can also have the option to ask their regular doctor to administer those vaccines after the evaluation by the civil surgeon. If the Applicant chooses that option, the applicant will have to show the records to the civil surgeon to note on Form I-693.
For more information regarding the Vaccination Requirements, visit the USCIS website.
During the Exam
The medical examination entails a review of the Applicant’s medical history and a physical examination.
Communicable Diseases of Public Health
The civil surgeon is required to perform specific tests for tuberculosis, syphilis, and gonorrhea depending on the Applicant’s age. The medical examination also requires the civil surgeon to evaluate for other sexually transmitted diseases and Hansen’s disease (leprosy).
Physical or Mental Disorders
The civil surgeon will ask you general questions during the medical examination to determine whether the Applicant has any physical (medical diagnosis) or mental disorders (psychiatric diagnosis) including any diagnosis of substance-related disorders that involve any substance that is not listed in Schedule I, II, III, IV, or V of section 202 of the Controlled Substances Act (for example, diagnosis of an alcohol-related disorder). In addition, if the civil surgeon finds that the Applicant has a physical or mental disorder with associated harmful behavior, the Applicant may apply for a waiver.
There must be both a physical or mental disorder and harmful behavior to make an Applicant inadmissible based on this ground. Neither harmful behavior nor a physical or mental disorder alone renders an Applicant inadmissible on this ground. Harmful behavior is defined as behavior that may pose, or has posed, a threat to the property, safety, or welfare of the Applicant or others.
Drug Addiction and Drug Abuse
The civil surgeon will review your medical history during the medical examination and ask you questions necessary to determine whether you are currently using any drugs or other psychoactive substances or have used them in the past. This includes any prescription drugs and the use of marijuana or cannabis. For more information on visit, our How Marijuana can Affect your Immigration Case page.
Many tattoos are completely innocent, and immigration officials know this. If the Applicant's tattoos are easy to understand and clearly not a mafia or gang sign, then the Applicant should have nothing to worry about.
During the medical examination, the civil surgeon may ask the Applicant to remove his or her clothes and will note any tattoos that he or she may have. While civil surgeons in the United States are bound by the privacy rules found under federal law (HIPAA) that may limit what they can and cannot say to the immigration authorities, it is always safest to assume that the civil surgeons may share their findings with them.
Information for Women
Female Applicants may have the examination even if they are having a menstrual period.
If chest X-rays are required as part of the medical examination, the Applicant should inform the civil surgeon if there is a possibility that she may be pregnant.
After the Exam
After the examination, the doctor will inform the Applicant when he or she can return to pick up the final exam results, and if the Applicant needs any vaccines or follow-ups.
When the Applicant returns to collect the final exam results, the civil surgeon will ask the Applicant to sign the form and will give the Applicant the final exam in a sealed envelope. DO NOT OPEN THE ENVELOPE. The medical examination envelope is to be opened by USCIS, not by the Applicant.
The doctor may give you a copy of the exam for your personal records.
K or V Nonimmigrants Applying for Adjustment of Status
K and V nonimmigrants applying for Adjustment of Status are not required to repeat the medical examination, if the application was filed within one year of the date of the original medical examination, and:
- The medical examination did not reveal a Class A medical condition, or
- The Applicant received a conditional waiver in conjunction with the K or V nonimmigrant visa or the change of status to V and the Applicant submits evidence of compliance with the waiver terms and conditions.
Health-Related Grounds of Inadmissibility
U.S. Immigration Law divides the health-related grounds of inadmissibility into the following four general categories:
- Communicable diseases of public health significance;
- Lack of proof of having received required vaccinations;
- Physical or mental disorders with associated harmful behavior or a history of associated harmful behavior; and
- Drug abuse or addiction.