What will my immigration medical exam include?
Check your exam
Answer four questions to see the tests and vaccines for your age, what to bring and how to hand in the sealed form. It gives general information from USCIS and CDC rules, not medical or legal advice. The civil surgeon decides what you need.
The checker needs JavaScript. Every rule it uses is in the tables below.
Your exam
Required tests by age
CDC’s technical instructions set the lab tests by age. HIV is not part of the exam, and there is no routine drug test.
| Test | Who needs it | Note | Source |
|---|---|---|---|
| Tuberculosis (IGRA blood test) | Age 2 and older | A positive result needs a chest x-ray. | CDC tuberculosis instructions for civil surgeons (opens in a new tab) |
| Syphilis (blood test) | Ages 18–44 | Other ages only if there is reason to suspect infection. | CDC syphilis instructions for civil surgeons (opens in a new tab) |
| Gonorrhea (urine test) | Ages 18–24 | Other ages only if there is reason to suspect infection. | CDC gonorrhea instructions for civil surgeons (opens in a new tab) |
| HIV | Not tested | HIV testing is not a requirement (CDC). | CDC tuberculosis instructions for civil surgeons (opens in a new tab) |
| Drug screen | Not part of the routine panel | The surgeon takes a medical history instead. | CDC mental health instructions for civil surgeons (opens in a new tab) |
Vaccines by age: CDC Table 1
The civil surgeon uses your age on the day of the exam and CDC’s Table 1 to decide which vaccines you need. This is that table, cell for cell. For each required vaccine you are not up to date on, the civil surgeon gives at least one dose at the exam. You are not expected to finish a whole series first.
| Vaccine | Birth–1 month | 2–11 months | 12 months–6 years | 7–10 years | 11–17 years | 18–64 years | 65 years and older |
|---|---|---|---|---|---|---|---|
| DTaP (diphtheria, tetanus and pertussis), childhood doses | NO | YES | NO | ||||
| Tdap or Td (tetanus, diphtheria, pertussis) | NO | Sometimes* | YES, Refer to ACIP Tdap/Td notes for adults without history of primary vaccination series | ||||
| Polio | NO | YES. Refer to ACIP Poliovirus notes for adults without history of primary vaccination series | |||||
| Measles, mumps and rubella (MMR) | NO | YES, if born in 1957 or later | |||||
| Rotavirus | NO | YES Six weeks to Eight months | NO | ||||
| Hib (Haemophilus influenzae type b) | NO | YES 2 through 59 months old | NO | ||||
| Hepatitis A | NO | YES 12 months through 18 years old | NO | ||||
| Hepatitis B | YES, through 59 years old | NO | |||||
| Meningococcal (MenACWY) | NO | YES 11 through 18 years old | NO | ||||
| Varicella (chickenpox) | NO | YES | |||||
| Pneumococcal | NO | YES, 2 through 59 months old (administer PCV) | NO | YES | |||
| Influenza (flu) | NO, if less than six months old | YES, > 6 months (Annually. See ACIP notes for more information.) | |||||
Tdap or Td (tetanus, diphtheria, pertussis): *Children 7-10 years old sometimes need a dose of Tdap depending on their vaccine history. Rotavirus: Rotavirus vaccination should not be initiated for infants aged 15 weeks 0 days or older. Hepatitis A and MenACWY say “through 18 years old,” but the 18–64 column reads NO, so ask the civil surgeon whether they apply at 18.
- For this exam, CDC treats flu season as September 1 to March 31. Outside those dates the flu vaccine isn’t required. CDC vaccination FAQ (opens in a new tab)
- A blood test showing immunity (a titer) is accepted for measles, mumps, rubella, hepatitis A, hepatitis B, polio (all three types) and varicella.
- CDC accepts written vaccination records that show the date of each dose (month, day and year). A dose you remember but can’t document does not count. If a record isn’t in English, CDC makes you responsible for providing a reliable English translation.
- COVID-19 vaccination is no longer part of the requirement. It ended on January 22, 2025.
More detail on records, titers and waivers is in our vaccination guide.
When a chest x-ray comes up
Only if your TB blood test is positive, or the civil surgeon finds signs or symptoms of TB or known HIV infection. CDC requires a chest x-ray in those cases. An x-ray is not part of every exam, which is why almost no published exam price includes one. Our guide explains what happens after a positive TB test. Source: CDC tuberculosis instructions (opens in a new tab).
The sealed envelope, by filing method
- The civil surgeon must give you the completed Form I-693 in a sealed envelope. Do not accept it if it is not sealed.
- If you file Form I-485 by mail, submit that original sealed envelope with your application.
- If you file Form I-485 online, USCIS instructs you to open the sealed envelope and upload the completed Form I-693. Keep the original form and the envelope until USCIS makes a final decision. USCIS may review them at an interview or ask you to submit them.
- Ask the clinic for a separate copy for your records.
- Since December 2, 2024, most people filing Form I-485 must include Form I-693 with the application.
Sources: USCIS, Form I-693 (opens in a new tab) and the USCIS alert on filing the I-693 with Form I-485 (opens in a new tab).
What to bring
- A government-issued photo ID, such as a passport
- Every vaccination record you have, with the date of each dose
- An English translation of any record that isn’t in English
- Past TB test results and chest x-ray reports, if you have any
- A list of the medications you take
- Form I-693, unsigned, if the clinic asks you to bring it. You sign it in front of the civil surgeon.
- Payment. Vaccines, titers and a chest x-ray are often billed separately, so ask for the total.
- A parent or legal guardian, and the child’s ID and records
The full checklist of what to bring covers children, interpreters and families booking together.
Related
- Current I-693 rules, with the date each one changed.
- Is my I-693 still valid? Check a form you already have.
- 2026 I-693 price index: what exams cost and what the price includes.
- The complete I-693 medical exam guide.