Immigration Physical & Form I-693 Questions, Answered

The I-693 exam is the immigration medical examination that a USCIS designated civil surgeon performs and records on Form I-693. It covers a physical exam, a vaccination review, and screening for certain communicable diseases, and it proves you are not inadmissible on health grounds.

An immigration physical is the same thing as the I-693 medical exam. It is a health check required from most green card applicants, done by a USCIS authorized civil surgeon, and the results are sealed and filed with your application rather than given to you as a normal medical report.

Most people filing Form I-485 to adjust status need the exam, including spouses of U.S. citizens, employment based applicants, and family preference applicants. Some applicants, such as certain refugees who were examined within the last year, may only need the vaccination portion completed.

Yes, in nearly every adjustment of status case. Since December 2, 2024, USCIS can reject a Form I-485 that is filed without Form I-693 or the required partial form, so the exam is now part of your filing package rather than something you bring to the interview later.

The civil surgeon reviews your medical history, checks height, weight, blood pressure, vision, heart, lungs, abdomen, skin, and lymph nodes, reviews your vaccination records, and orders screening tests such as the TB blood test. There is no lengthy hospital procedure involved.

The appointment itself usually takes 30 to 60 minutes. Getting the completed Form I-693 back takes longer because lab results have to come in first, so plan on one visit for the exam and a short wait or second visit to collect the sealed envelope.

A Form I-693 signed by a civil surgeon on or after November 1, 2023 has no fixed expiration date, but under USCIS guidance effective June 11, 2025 it is only valid for the application it was filed with. If that application is denied or withdrawn, a new exam is needed.

USCIS only accepts the current form edition. For forms signed on or after July 3, 2025 that is the 01/20/25 edition. Download the form fresh from the USCIS website before your appointment, because an outdated edition can get your filing rejected.

A civil surgeon performs the exam inside the United States for adjustment of status cases and completes Form I-693. A panel physician performs the equivalent exam abroad for consular processing and immigrant visa applicants. You cannot substitute one for the other.

A civil surgeon is a licensed physician that USCIS has specifically designated to perform immigration medical exams and sign Form I-693. The designation is granted by USCIS, is tied to a specific practice location, and can be checked against public USCIS records.

Only if your doctor holds a current USCIS civil surgeon designation. A family physician, urgent care clinic, or specialist without that designation cannot sign Form I-693, and USCIS will reject an exam completed by an unauthorized provider.

Search by state, city, or ZIP code in the USCISMD directory, then compare doctors on price, languages spoken, office hours, and how fast they return the sealed envelope. You can also call the USCIS Contact Center for a list of designated doctors in your area.

Check the doctor against the official USCIS civil surgeon locator or call the USCIS Contact Center, and confirm the designation matches the exact office address where you will be examined. Every listing on USCISMD is checked against public USCIS records before it is published.

Yes. USCIS does not require you to use a doctor in the state where you live or where your case is being processed, so you can travel to a nearby city or state if the price or the appointment availability is better there.

Most civil surgeons work by appointment because the exam takes a dedicated slot and often involves lab work. Some larger clinics accept walk-ins during set hours. Call ahead to confirm the exam type, the fee, and the documents to bring.

Yes. Many civil surgeons and their staff speak Spanish, Hindi, Mandarin, Arabic, Russian, Vietnamese, Tagalog, and other languages. USCISMD lists languages on each doctor profile so you can filter before you call, and you may also bring your own interpreter.

Look at the nearest larger city or metro area, since designated doctors cluster around urban centers. Our city and state pages list nearby options with distance, so you can pick the closest practical appointment rather than waiting for a local one.

Most civil surgeons charge between $150 and $500 for the exam and Form I-693 completion. The price depends on your city, the clinic, and whether lab work is bundled in. Comparing two or three doctors in your area often saves a meaningful amount.

Usually not. The immigration medical exam is treated as an administrative exam rather than medically necessary care, so most health plans decline it. Some plans will still cover the vaccines or the TB test, so it is worth asking your insurer about those line items.

Missing vaccines are billed on top of the exam fee and commonly add $100 to $600 depending on how many doses you need. Getting vaccines at a county health department or pharmacy before the appointment is often cheaper than getting them at the clinic.

Prices reflect local costs, whether the TB blood test and vaccines are included, and how quickly the office returns the sealed envelope. A quoted price is not always all inclusive, so ask what the fee covers before you book.

Free exams are rare, but community health centers, federally qualified health centers, and some nonprofit clinics offer reduced fees or sliding scale pricing. Refugees and asylees can sometimes use a health department that is blanket designated for the vaccination portion.

You pay the civil surgeon directly. USCIS does not charge a separate fee for Form I-693 and does not collect the exam cost, so the clinic sets and collects its own price.

Refund rules are set by each clinic, not by USCIS. Many offices refund a deposit if you cancel well in advance but keep it for late cancellations or no-shows. Ask about the cancellation policy when you book.

The CDC schedule covers diseases including measles, mumps, rubella, polio, tetanus and diphtheria, pertussis, hepatitis A and B, varicella, influenza, Haemophilus influenzae type b, meningococcal disease, and pneumococcal disease. Which ones apply to you depends on your age and the season.

No. USCIS waived the COVID-19 vaccination requirement for adjustment of status applicants as of January 2025, and the CDC removed it from the civil surgeon vaccination schedule. A civil surgeon should not refuse to complete your form over COVID-19 documentation.

Yes, if the record is an official written document that shows the vaccine name and the date of each dose. Bring the original, and a translation if it is not in English. Good records are the single easiest way to avoid paying for repeat doses.

You have two options: request records from your former doctor, school, or state immunization registry, or ask the civil surgeon for blood titer testing that proves immunity. If neither works, the doctor can simply administer the missing doses.

There are three routes: the civil surgeon marks a vaccine as not medically appropriate or not age appropriate, the vaccine is not available, or you apply for a religious or moral conviction waiver on Form I-601. The first route is handled at the exam; the third is a separate USCIS filing.

No. The required list is age based, so children generally need more of the childhood series while older adults need fewer vaccines. The civil surgeon compares your child's record against the CDC age-by-age table and only requires what applies.

Usually yes. Only the first dose of a multi-dose series is needed before the civil surgeon can sign your form, so you rarely have to wait weeks for a full series to finish before filing.

For some diseases, yes. Titer testing can show existing immunity to measles, mumps, rubella, varicella, and hepatitis, which lets the civil surgeon record you as immune instead of vaccinating you again. Titers cost money too, so compare that price against the vaccine price.

Screening focuses on communicable diseases of public health significance. For most adults this means a tuberculosis blood test, plus syphilis and gonorrhea testing for applicants in the required age range. Additional tests are ordered only if the physical exam suggests a problem.

Yes, if you are 2 years or older. The CDC requires an interferon gamma release assay blood test rather than the old skin test, so plan for a blood draw and a short wait for results before your form can be signed.

A positive test does not mean you are denied. The civil surgeon orders a chest x-ray, and if that is clear, you are recorded as having latent infection and can normally proceed. Active TB must be treated before the form can be certified.

Only if your TB blood test is positive, or if the doctor sees symptoms that call for it. Applicants who are pregnant can have the x-ray with abdominal shielding, or ask to defer it, so tell the office before the exam.

There is no routine urine drug screen. The civil surgeon does assess for drug abuse or addiction through history and examination, and can order testing if there is a specific reason to.

It can. Marijuana remains a controlled substance under federal law regardless of state legalization, and admitted use can lead to a finding of drug abuse or addiction. This is a situation where speaking to an immigration attorney before your appointment is genuinely worth it.

No. HIV was removed from the list of communicable diseases of public health significance in 2010, and HIV testing is no longer part of the immigration medical exam or a ground of inadmissibility.

The civil surgeon screens for physical or mental disorders with associated harmful behavior, not for mental health treatment in general. Having depression, anxiety, or being in therapy is not by itself a ground of inadmissibility.

There is no pass or fail grade. The civil surgeon records findings, and only a small set of conditions creates inadmissibility, most of which can be resolved with treatment or a waiver. Most findings simply get documented and the case moves on.

Bring a government issued photo ID, your complete vaccination records, and Form I-693 with your sections filled in but not signed. Add your I-485 receipt notice, past medical records, and a list of current medications if you have them.

Gather vaccination records early, download the current form edition, and call the office to confirm the fee, the documents, and whether lab work happens on site. Preparation is what prevents a second visit and a second bill.

No. The immigration medical exam does not require fasting, and the TB blood test does not either. Eat normally and drink water before your appointment.

Only partially. The doctor needs to listen to your heart and lungs and check your skin and lymph nodes, so you may be asked to remove outer clothing or change into a gown. A full body or genital exam is not part of the standard exam.

No. Fill in your personal details but sign only in front of the civil surgeon, who must witness your signature. Signing early is one of the most common reasons a form gets sent back.

Yes. You may bring an interpreter or a relative, and many clinics prefer it if you are not comfortable in English. A parent or guardian must accompany a child.

A valid government issued photo ID such as a passport, driver's license, or state ID. Children can usually be identified with a passport, birth certificate, or school record. The name on your ID should match the name on your form.

Yes, though clinic cancellation policies vary and a deposit may be non-refundable if you cancel late. Rescheduling does not affect your USCIS case as long as you still file the completed form with your application.

Most offices complete and seal the form within 1 to 7 business days after the exam, once lab results arrive. Some offer same day completion at a premium. Ask about turnaround when you book if you are close to a filing deadline.

No. The civil surgeon seals Form I-693 in an envelope and signs across the flap. If the seal is broken, USCIS can treat the form as invalid and you may need a new exam, so file the envelope unopened.

File the sealed envelope together with your Form I-485 package. Since December 2, 2024, USCIS can reject an I-485 that arrives without the medical exam, so it is no longer something to bring to the interview.

Yes. Ask the civil surgeon for a duplicate copy for your own records at the time of the exam. Keep it separate from the sealed envelope, which must stay closed.

Contact the civil surgeon who performed your exam. Many will issue a replacement sealed envelope from the same exam for a small fee if it is recent enough, which is far cheaper than repeating the whole exam.

A Request for Evidence means USCIS found something missing or unclear, often a blank vaccination box, a missing signature, or an outdated form edition. Take the notice back to your civil surgeon, who can usually correct and reseal the form.

A form signed on or after November 1, 2023 has no expiration date while your application stays pending, so a long interview wait does not invalidate it. An officer can still request an updated exam if there is reason to believe your health has changed.

Yes. Under the policy effective June 11, 2025, Form I-693 is only valid for the application it was filed with, so a withdrawn or denied case means a fresh exam for any future filing.

Yes. Every applicant filing Form I-485, including infants and children, needs an exam, though the tests differ by age. The TB blood test generally applies from age 2, and a parent or guardian must attend.

Yes. Tell the office you are pregnant when you book. The chest x-ray, if one is needed, can be done with abdominal shielding or deferred, and some vaccines may be postponed and noted on the form.

K-1 applicants have an exam abroad with a panel physician before the visa. When they later file Form I-485 in the United States, they usually need a civil surgeon to complete at least the vaccination portion of Form I-693.

It depends on timing. Refugees examined overseas within the past year may only need the vaccination record completed, and health departments that are blanket designated can often do that portion. Asylees generally need a full exam with a civil surgeon.

Usually yes, if you are now adjusting status in the United States. An overseas panel physician exam supports an immigrant visa, not a Form I-485, although a recent overseas exam can sometimes reduce what the civil surgeon has to repeat.

Requirements differ by benefit type. Some applications require a full exam, some require only the vaccination record, and some require nothing unless USCIS asks. Check the form instructions for your specific application before paying for an exam.

Call ahead and explain your needs. Many clinics can arrange accessible rooms, extra time, or an accompanying caregiver, and a few offer home or facility visits. The exam requirements themselves do not change.

No. USCISMD is an independent directory that collects publicly available civil surgeon information so applicants can find and compare doctors. We are not affiliated with, endorsed by, or acting on behalf of USCIS or the Department of Homeland Security.