What is the immigration medical exam?

The immigration medical exam, also known as the green card medical exam, is a health screening required by U.S. immigration law. Its purpose is to identify medical conditions that could affect public health or immigration eligibility. The exam follows strict guidelines set by the Centers for Disease Control and Prevention (CDC) and USCIS.

During the exam, a USCIS-authorized civil surgeon completes Form I-693, which records your medical history, physical examination results, vaccination status, and required test outcomes. USCIS uses this form to confirm that you meet health-related admissibility requirements before approving your green card.

The exam is not meant to judge your overall health or deny applications based on manageable conditions. Instead, it focuses on specific categories such as communicable diseases of public health significance, required immunizations, certain mental health conditions with harmful behavior, and current drug abuse or addiction.

Who needs an immigration medical exam?

Whether you need an immigration medical exam depends on the type of permanent residence you are applying for and your visa category.

Adjustment of status applicants

If you are filing Form I-485 to adjust status to a green card from within the United States, you are generally required to submit a completed immigration medical exam. This applies to family-based, employment-based, diversity visa, refugee, asylee, and most other adjustment categories.

Even if you previously completed a medical exam for another visa, you may still need a new exam depending on timing and eligibility rules.

Consular processing applicants

If you are applying for an immigrant visa through a U.S. consulate abroad, you will still undergo a medical examination; however, it will be conducted by a panel physician approved by the U.S. Department of State, rather than a civil surgeon. The process is similar, but the results are sent directly to the consulate instead of being given to you in a sealed envelope.

Certain nonimmigrant categories

Some non-immigrant visas, such as K-1 fiancé(e) visas and certain refugee or asylee categories, require a medical exam. Most temporary visas, including tourist, student, and work visas, do not need a medical exam unless you later apply for permanent residence.

Finding a USCIS-designated civil surgeon

Choosing the right doctor is critical, since USCIS only accepts exams completed by authorized civil surgeons.

Civil surgeon requirements

A civil surgeon is a licensed U.S. physician who has received special authorization from USCIS to conduct immigration medical exams. These doctors are trained on immigration-specific health requirements and how to properly complete Form I-693.

Exams performed by doctors who USCIS does not currently authorize are invalid, even if the doctor is otherwise licensed.

Using the USCIS doctor search tool

USCIS provides an official online search tool that allows you to find authorized civil surgeons by ZIP code or city. The directory includes contact details and is updated regularly as doctors gain or lose authorization.

Using the USCIS search tool is the safest way to confirm that a doctor is approved at the time of your exam.

Verifying authorization before scheduling

Before booking an appointment, it is essential to verify that the doctor is listed in the USCIS Civil Surgeon Directory. Authorization status can change, so relying on advertisements or word-of-mouth alone can lead to costly mistakes.

If a doctor claims they can perform immigration exams but does not appear in the USCIS directory, the exam will not be accepted.

Scheduling your appointment

Once you find an authorized civil surgeon, you will contact their office directly to schedule your exam. When booking, be sure to ask about the total costs, what documents to bring, how long the appointment will take, and how long it typically takes to finalize the results.

Many applicants schedule the exam close to their filing date to avoid timing issues, especially if lab results or vaccinations are required.

Required vaccinations for the immigration medical exam

Vaccination compliance is a core part of the immigration medical exam. USCIS follows CDC guidelines to determine which vaccines are needed based on age, medical history, and public health considerations.

Applicants must show proof of vaccination against certain preventable diseases. If documentation is missing or incomplete, the civil surgeon will determine whether vaccines must be administered or whether immunity can be proven through blood tests.

CDC vaccination requirements

Required vaccines may include measles, mumps, and rubella (MMR), polio, tetanus and diphtheria toxoids, pertussis, hepatitis A, hepatitis B, varicella (chickenpox), influenza (seasonal), meningococcal disease, pneumococcal disease, rotavirus, and Haemophilus influenzae type B. Not every vaccine applies to every applicant.

Age-appropriate requirements

Vaccination requirements depend on your age at the time of the exam. Children typically need more vaccines, while adults may only need a subset. The civil surgeon determines which vaccines apply based on CDC schedules and your prior immunization history.

Acceptable proof of vaccination

You can provide official vaccination records from doctors, schools, military service, or government health agencies. International vaccination records are acceptable if they are reliable and clearly documented. Blood tests showing immunity may be used to determine eligibility for certain vaccines.

Receiving missing vaccinations

If you are missing required vaccines, the civil surgeon may administer them during your appointment or refer you to another provider. The medical exam cannot be completed until vaccination requirements are satisfied or properly documented.

Preparing for your medical examination

Preparation helps avoid delays and reduces the need for repeat visits. Arriving with the correct documentation and information allows the exam to move smoothly.

Documents to bring

Bring a government-issued photo ID, your vaccination records, medical records for any chronic conditions, a list of current medications, and payment for the exam. Glasses or contact lenses should also be brought if you use them.

Vaccination record preparation

Gather vaccination records early, especially if you received immunizations outside the U.S. If records are in another language, translations may be required. Organizing records ahead of time reduces the likelihood of repeat vaccines or extra testing.

Disclosure and honesty

You should answer all medical questions truthfully. Omitting or misrepresenting information can result in severe immigration consequences. Honest disclosure allows the civil surgeon to document conditions correctly and identify whether treatment or waivers are available.

Inadmissible health conditions

Some medical findings can affect immigration eligibility, though many issues can be treated or resolved.

Communicable diseases of public health significance

Active tuberculosis, untreated syphilis, gonorrhea, and Hansen’s disease are grounds of inadmissibility. Treatment must be completed and documented before immigration approval.

Failure to meet vaccination requirements

Applicants who do not complete required vaccinations and lack a valid medical exemption may be deemed inadmissible until requirements are met or a waiver is approved.

Physical or mental disorders with harmful behavior

A condition only affects admissibility if it involves current behavior that poses a threat to safety or property. Diagnosis alone is not enough. Additional evaluations may be required.

Drug abuse or addiction

Current drug abuse or addiction is a ground of inadmissibility. Past use without current abuse generally does not disqualify an applicant.

What happens after the exam

Once all tests and vaccinations are complete, the civil surgeon finishes Form I-693. Processing typically takes one to two weeks if lab results are required.

You will receive the completed form in a sealed envelope. Do not open it. Opening the envelope invalidates the exam and requires a new one to be issued. The civil surgeon may provide you with a copy of your vaccination record for your personal records.

Common issues and how to avoid them

Many delays occur due to preventable mistakes.

Incomplete vaccination records

Missing documentation often results in repeat vaccinations or blood tests. Start collecting records early to avoid unnecessary costs.

Using an unauthorized doctor

Only USCIS-designated civil surgeons are authorized to perform valid exams. Always verify authorization through the USCIS doctor search tool.

Opening the sealed envelope

Opening the Form I-693 envelope voids the exam. Keep it sealed until USCIS requests it.

Timing issues

Completing the exam too early can cause it to expire before filing. Coordinating timing with your application is essential.

Conclusion

The immigration medical exam is a mandatory step for most green card applicants. It includes a medical history review, physical exam, tuberculosis screening, blood tests, and vaccination verification conducted by a USCIS-authorized civil surgeon using Form I-693.

Preparing in advance, choosing an authorized doctor, gathering vaccination records, understanding costs, and timing the exam correctly can prevent delays. When handled properly, the medical exam becomes a straightforward part of the immigration process rather than an obstacle.