Immigration medical exam: frequently asked questions

It is the health screening USCIS requires from most people applying for a green card from inside the United States. The results are recorded on Form I-693, the Report of Immigration Medical Examination and Vaccination Record. It checks for a short list of communicable diseases, confirms your required vaccinations and records your medical history. It is not a general checkup, and it does not replace your own doctor.

Only a physician USCIS has designated as a civil surgeon. A medical license alone is not enough, and a form signed by a doctor who is not designated will not be accepted. Every clinic in our network is led by a designated civil surgeon, and you can confirm any doctor’s designation yourself on the official USCIS Find a Doctor locator at my.uscis.gov/findadoctor.

Before you file. Since December 2, 2024, most people filing Form I-485 must include the sealed I-693 in the same package, and USCIS may reject an I-485 that arrives without it. Because the form is also tied to the one application it is filed with, the practical approach is to book the exam once the rest of your filing is nearly ready. If an attorney is handling your case, follow their timing.

Forms signed on or after November 1, 2023 no longer expire on a calendar date. Under the policy that took effect June 11, 2025, however, a form is valid only for the application it was filed with. If that application is denied or withdrawn, you will need a new exam for any future application. Forms signed before November 1, 2023 keep the older two-year window.

The visit itself is usually short. The form can only be completed once every required result is back, so the sealed envelope is typically ready a few business days later; each clinic publishes its usual turnaround on its clinic page. A positive TB blood test adds a chest x-ray, which can add time. If you are working to a deadline, say so when you book.

A tuberculosis blood test (IGRA) for everyone age 2 and older, a syphilis blood test for ages 18 to 44, and a gonorrhea urine test for ages 18 to 24. Outside those age ranges, testing is done only if there is a reason to suspect infection. The civil surgeon also performs a physical exam, reviews your vaccinations and takes a medical history.

A drug screen is not part of the routine immigration medical exam. The civil surgeon takes a medical history, which includes questions about drug and alcohol use, and must record the findings accurately. How any part of your history bears on your case is a legal question, so if it worries you, speak with an immigration attorney before your appointment. A reputable clinic will never coach you on what to say.

A positive blood test does not mean you have active tuberculosis. You will need a chest x-ray. If the x-ray is normal and you have no symptoms, CDC classifies the result as latent TB infection (Class B2), and treatment is not required to complete your immigration medical exam. The result is reported to the local health department, and treating latent TB is still worth doing for your own health.

No. HIV was removed from the list of communicable diseases of public health significance in 2010 and is not part of the immigration medical exam.

For most people, no. USCIS guidance states that neither harmful behavior nor a physical or mental disorder alone makes an applicant inadmissible on this ground; the two must occur together. Common conditions such as diabetes, high blood pressure, asthma, thyroid disease or a managed mental health condition are not, by themselves, a bar. Bring your medication list and records so the form is accurate.

Age-appropriate vaccines against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, varicella, hepatitis A, hepatitis B, meningococcal disease, pneumococcal disease, rotavirus and Hib, plus influenza during flu season (September 1 to March 31). Not every vaccine applies to every person; it depends on your age and your records. COVID-19 vaccination is no longer required.

No. The COVID-19 vaccination requirement for the immigration medical exam ended on January 22, 2025. Many websites have not been updated and still list it.

That is common and fixable. Bring whatever you have, in any language; partial and foreign-language records still count, with an English translation for any record not in English. For several diseases, including measles, mumps, rubella, hepatitis A, hepatitis B, polio and varicella, a blood test showing immunity (a titer) is accepted in place of a record. Otherwise the missing vaccines are given. Vaccines and titers are usually priced separately from the exam, so ask the clinic before anything is done.

Each clinic in our network publishes its exam fee on its clinic page, together with a line-by-line list of what the fee includes and what is billed separately. Vaccines you still need and a chest x-ray, if one is required, are usually extra. Most health insurance plans do not cover the immigration medical exam because it is required for an immigration benefit rather than for treatment.

Advertised prices often cover different things. Some include all required lab work and the sealed form; others bill labs separately, send you to an outside lab, or require a second visit for results. Compare the total you will actually pay: exam, TB blood test, syphilis and gonorrhea testing where required, vaccine review, and the sealed form. Our guide to exam costs lists the questions to ask.

Yes. Families applying together can usually be scheduled back-to-back. Requirements differ by age: TB testing starts at age 2, and syphilis and gonorrhea testing apply only within adult age ranges, so a child’s exam is often shorter. For a family booking, calling or texting the clinic is usually faster than booking each person online.

An unexpired government photo ID such as a passport, every vaccination record you can find, records of any past positive TB test or TB treatment, a list of your medications, and records of any ongoing condition. If you have printed Form I-693, bring it unsigned: you must sign it in front of the civil surgeon.

No. The completed I-693 goes into a sealed envelope, and USCIS will not accept it if the seal has been broken or the envelope altered. Keep it closed and include it with your filing exactly as you received it. Ask the clinic for a copy of the form for your own records.

Yes. Clinics in our network coordinate with immigration attorneys and their paralegals on scheduling, deadlines and delivery of the sealed form. If your attorney has specific instructions, mention them when you book. Attorneys can also contact us directly through our page for immigration attorneys.

No. National Immigration Medical Exams is a private network of independent medical practices. We are not affiliated with USCIS, CDC or any government agency. USCIS designates the individual civil surgeons; the exam itself is provided by the practice named on each clinic page.