Essential Facts
The immigration medical exam is a required step for all green card applicants. Every applicant must complete this exam to ensure they meet U.S. public health standards and are not inadmissible on medical grounds.
Before attending your appointment, make sure to bring the proper documents such as your vaccination records and valid identification. The validity of your medical exam depends on where and when you apply. Importantly, the exam must be conducted only by a USCIS-approved civil surgeon or a Department of State-approved panel physician.
At Green Card Link, its immigration attorneys can guide you through every step of the process, ensuring you comply with all USCIS requirements and deadlines.
Schedule a consultation with an immigration attorney at Green Card Link if you have any questions about the medical exam or your green card application.
What Is an Immigration Medical Exam?
An immigration medical exam is an official health screening designed to confirm that you do not pose a public health risk to the United States. During this exam, an authorized physician will verify that:
- You are free from certain communicable diseases.
- You have received all required vaccinations.
- You do not have any health conditions that could make you inadmissible.
Depending on your case, your green card application will proceed through either Consular Processing (if you apply from outside the U.S.) or Adjustment of Status (AOS) (if you apply within the U.S.). Both require a medical exam as part of the approval process.
What to Expect During the Exam
- A full physical, mental, and cognitive evaluation
- Drug and alcohol screening
- Review of your medical history and immunization records
- Blood and urine tests for infectious diseases
- Tuberculosis (TB) screening
- Assessment for specific medical conditions
After completing your exam:
- If you are applying inside the U.S., the physician will give you a sealed Form I-693 envelope to submit to USCIS. Do not open this envelope.
- If you are applying from abroad, the results are typically sent directly to the U.S. consulate or embassy electronically.
Green Card Medical Exam Overview
Question | Inside the U.S. | Outside the U.S. |
What to Bring | Government-issued ID, full medical history, vaccination records, prior X-rays, letter for ongoing treatments, payment, and health insurance card | Passport photos, visa interview letter, DS-260 confirmation, valid passport, vaccine records, payment, health insurance card (if applicable) |
Cost of Exam | $250 – $400 USD | $150 – $500 USD |
Duration | 1–2 hours | About 2 hours |
Tests Performed | Physical exam, vaccination review, TB test, blood/urine tests, mental/cognitive evaluation, and medical history review | Physical exam, chest X-ray, TB testing, blood tests for syphilis, and full organ and skin examination |
When to Schedule | Before filing Form I-485 (Adjustment of Status) | When advised by the National Visa Center (NVC) |
Booking Method | Schedule with a USCIS-designated civil surgeon | Embassy/Consulate will provide instructions |
Validity of Results | Valid for two years from the civil surgeon’s signature date | Determined by the embassy/consulate |
How to Schedule an Immigration Medical Exam
The medical exam is a mandatory step for every green card applicant. Before booking, determine which category applies to you:
- Inside the U.S. (Adjustment of Status): You must schedule your exam with a USCIS-approved civil surgeon and complete Form I-693.
- Outside the U.S. (Consular Processing): Schedule your exam with a Department of State-approved panel physician in your home country.
I-693 Medical Exam: Inside the United States
Step 1: Schedule Your Appointment
Use the official “Find a Civil Surgeon” tool on the USCIS website to locate an approved doctor. Civil surgeons follow the Centers for Disease Control and Prevention (CDC) technical guidelines when conducting immigration medical exams.
Step 2: Bring Required Documents
Prepare the following before your appointment:
- Form I-693 (Report of Medical Examination and Vaccination Record)
- Government-issued photo ID (passport, driver’s license, or translated birth certificate)
- Vaccination records showing all required immunizations
- Health insurance card (ask if your plan covers the exam)
- Payment (confirm accepted forms and compare rates between surgeons)
Step 3: Complete Form I-693
Fill out Part 1: Information About You before the appointment, but do not sign the form until instructed by the civil surgeon.
Step 4: Attend the Exam
During your appointment, the doctor will:
- Verify your identity.
- Evaluate for communicable diseases like tuberculosis, syphilis, and gonorrhea.
- Assess for mental or physical disorders linked to harmful behavior.
- Review for any drug abuse or addiction history.
- Confirm your vaccination status and administer any missing vaccines.
- Provide referrals for further testing if needed (e.g., chest X-ray follow-ups).
All follow-ups must be completed before the civil surgeon certifies your Form I-693.
Step 5: After the Exam
Once the exam is finished:
- Sign Part 2 of the form in the doctor’s presence.
- The civil surgeon will seal the completed Form I-693 in an official envelope labeled “DO NOT OPEN. FOR USCIS USE ONLY.”
- Keep a copy for your records, especially the vaccination summary.
Submit the sealed envelope with your Adjustment of Status application to USCIS. If your form is unsealed or altered, USCIS will reject it and require you to obtain a new one.
When there are no grounds for inadmissibility, your application can proceed smoothly toward approval.
Key Requirements for Form I-693
To be accepted by USCIS, your Form I-693 must:
- Be complete and legible.
- Include all required signatures and dates from both you and the physician.
- Contain any specialist referral evaluations (if applicable).
- Remain valid at the time of filing.
- Be submitted in a sealed envelope as instructed.
If any requirement is missing or if the envelope shows signs of tampering, USCIS will return the form for correction, delaying your green card process.
Panel Physician: Completing Your Immigration Medical Exam Outside the United States
If you are applying for a U.S. visa from abroad, the U.S. embassy or consulate handling your case will provide an official list of certified Department of State panel physicians. These are the only doctors authorized to perform your immigration medical examination before your visa interview.
Step 1: Wait for Instructions from the National Visa Center (NVC)
Before scheduling your medical exam, wait for guidance from the National Visa Center (NVC). You will receive instructions through the Consular Electronic Application Center (CEAC) or via email, explaining when and how to book your appointment with a designated panel physician.
Step 2: Schedule Your Medical Exam
Once you receive NVC instructions, you can contact an approved Department of State (DOS) panel physician in your country. Your immigration medical exam must be completed before your visa interview at the U.S. embassy or consulate.
Step 3: Prepare Required Documentation
Each U.S. embassy or consulate may have slightly different requirements, but you will generally need to bring the following items:
- Valid passport
- Visa interview appointment letter
- DS-260 confirmation page
- Passport-sized color photographs
- Immunization records, including proof of COVID-19 vaccination
- Completed medical questionnaire
- Any medical or specialist reports related to tuberculosis (TB) or other significant conditions
Step 4: Receiving and Submitting Your Results
After the medical exam, the panel physician will either send your results directly to the U.S. embassy or provide them to you in a sealed envelope. You must not open this envelope. Once this step is complete, you can proceed to your green card visa interview.
Immigration Medical Examination Fees
The cost of an immigration medical exam typically ranges from $150 to $500, depending on the country and physician. Additional fees may apply if vaccines or further testing are required.
If you are completing your process abroad, the U.S. Department of State provides links to each embassy or consulate where specific medical exam fees are listed.
For applicants in the United States, USCIS does not set or regulate medical exam costs; prices vary by civil surgeon or medical facility.
Preparing for Your Green Card Medical Exam
Proper preparation ensures that your green card application process proceeds without delay. Missing documents or incomplete vaccination records can result in follow-up appointments or even a Request for Evidence (RFE) from USCIS.
To ensure your exam goes smoothly, you may consult with an immigration attorney at Green Card Link who can help you review your required documents and prepare for your medical examination.
Schedule a Consultation
Our immigration attorneys at Green Card Link can guide you through every step of the process to help you avoid delays and ensure compliance with U.S. immigration medical requirements.
Required Vaccinations for Green Card Applicants
Vaccinations are a mandatory part of the immigration medical exam under U.S. immigration law. The U.S. Department of State requires certain immunizations to prevent communicable diseases. These may include:
Hepatitis A, Hepatitis B, Influenza, Influenza Type B (Hib), Measles, Meningococcal, Mumps, Pneumococcal, Pertussis, Polio, Rotavirus, Rubella, Tetanus and Diphtheria Toxoids, and Varicella.
The examining physician will determine which vaccinations are medically appropriate based on your age, medical history, and contraindications. If you are missing any required vaccines, the panel physician or civil surgeon may administer them during your appointment.
The Centers for Disease Control and Prevention (CDC) also provides technical instructions that guide physicians in assessing vaccination requirements and documenting results accurately.
The Centers for Disease Control and Prevention (CDC) also provides technical instructions that guide physicians in assessing vaccination requirements and documenting results accurately.
Documents to Bring to Your Immigration Medical Exam
To ensure a smooth process, bring the following documents to your appointment:
- Government-issued photo ID
- Full medical history
- Vaccination and immunization records
- Prior chest X-rays (if applicable)
- Letter from your physician outlining treatment for ongoing conditions
- Payment for medical exam (fees vary by location)
- Health insurance card
When to Complete the Immigration Medical Exam
- For applicants inside the U.S. (Adjustment of Status): Submit your Form I-693 medical report together with your I-485 application.
- For applicants outside the U.S. (Consular Processing): Complete the exam when instructed by the National Visa Center (NVC), and before your visa interview.
Validity Period of Immigration Medical Exams
- For Adjustment of Status applicants: Form I-693 is valid for two years from the date the civil surgeon signs it.
- For Consular Processing applicants: The validity period is determined by the U.S. embassy or consulate’s specific policies.
Referrals and Additional Testing
If the civil surgeon or panel physician determines that further evaluation or treatment is necessary, they may refer you for additional testing. The physician will not sign or finalize your I-693 form until all follow-up requirements are met.
Medical Conditions and Inadmissibility
The USCIS, CDC, and Department of Health define medical conditions that can make an applicant inadmissible to the United States. These include:
- Communicable diseases of public health concern
- Failure to show proof of required vaccinations
- Physical or mental disorders associated with harmful behavior
- Substance abuse or addiction
Applicants with Class B conditions—serious but non-disqualifying medical issues—may still be eligible for immigration, although these conditions might require additional documentation or treatment.
K or V Visa Holders and Medical Exam Validity
If you completed a medical examination before entering the United States, you generally do not need to repeat it if:
- You file Form I-485 within one year of your overseas medical exam; and
- No Class A medical condition was found; or
- A waiver for a Class A condition was granted, and all conditions of that waiver were met.
Get Expert Help from Green Card Link
Navigating medical exam requirements for your immigration case can be confusing. At Green Card Link, our experienced immigration attorneys ensure you meet all U.S. health-related requirements accurately and on time. Contact us today for a consultation and personalized guidance on your immigration medical exam process.
Immigration Medical Exam and Vaccination Requirements for Green Card Applicants
Proof of compliance with vaccination requirements is mandatory, even when a new medical examination is not needed. If you cannot provide proof, the doctor will complete the vaccination assessment portion of Form I-693 (Report of Medical Examination and Vaccination Record) to ensure you meet all U.S. Citizenship and Immigration Services (USCIS) health standards.
Refugees Applying for Adjustment of Status
Refugees must meet all vaccination requirements when applying for adjustment of status. This involves submitting the relevant sections of Form I-693, completed by a USCIS-designated civil surgeon.
In most cases involving overseas consular processing, medical exams are completed before entry into the United States and do not need to be repeated. However, if a Class-A medical condition is identified by a panel physician, the applicant must undergo a full repeat medical examination.
Refugee family members living in the U.S. who are adjusting their status must also complete a medical examination. The civil surgeon handling the process may request additional tests or vaccinations to ensure full compliance, even if a prior exam was conducted.
Asylees Applying for Adjustment of Status
Asylees are also required to complete an immigration medical examination, including a vaccination assessment, when filing for adjustment of status. In some cases, a new exam may not be necessary. For example, if the initial medical examination was completed overseas and:
- The A-file (alien case file) does not indicate a Class-A medical condition,
- The asylee applies for adjustment of status within one year of becoming eligible, and
- There is evidence in the A-file or through testimony that no Class-A condition was acquired after entry into the United States.
To demonstrate compliance, applicants must include a vaccination assessment completed by a civil surgeon as part of the adjustment of status application.
Immigration Medical Exam: Frequently Asked Questions
Who needs to take the immigration medical exam?
Every green card applicant must undergo an immigration medical examination as part of the application process.
Are children required to take a medical exam?
Yes. Children must also complete the exam, but the vaccination requirements vary by age.
What type of doctor performs the exam?
If applying within the U.S., a USCIS-approved civil surgeon must conduct the exam. If applying from outside the U.S., a panel physician authorized by the U.S. Department of State will handle the examination.
How much does the immigration medical exam cost?
Costs typically range from $250 to $400, depending on the clinic and location.
What should I bring to my medical exam?
Be sure to bring:
- Vaccination and immunization records
- Copies of medical history or recent X-rays (if applicable)
- Government-issued ID (passport, driver’s license, or travel permit)
- A doctor’s note if you’re undergoing treatment
- Payment or insurance card (if accepted)
- Form I-693 (if applying within the U.S.)
- Green card interview appointment letter (if applying overseas)
How do I schedule a medical exam?
Use the USCIS Civil Surgeon Locator tool to find an approved doctor in your area. Contact the doctor directly to schedule your appointment.
If applying from overseas, wait until you receive your green card interview appointment letter from the National Visa Center (NVC) before scheduling. Authorized doctors can be located through your nearest U.S. Embassy or Consulate.
How long does the medical exam take?
Most exams take one to two hours, depending on the facility.
What happens after the exam?
The physician will usually seal your results in an envelope for submission to USCIS. In some countries, results are sent directly to the U.S. Embassy.
What if I have a learning or intellectual disability?
Applicants must provide documentation of their condition, including any special educational or supervision needs relevant to the exam.
What if I’m missing some required vaccines?
If vaccination records are unavailable, the physician will determine what additional vaccines are required based on age and lab results.
What if I have an abnormal chest X-ray?
Bring prior chest X-ray films to your exam. The doctor may compare them with new X-rays to assess your condition.
What if I have a psychiatric or behavioral condition?
Applicants with a history of violent behavior or psychiatric illness must provide medical documentation, including diagnosis, treatment duration, and prognosis, to help the physician assess eligibility.
Can the medical exam or vaccination requirement be waived?
In limited circumstances, a waiver may be granted if a medical condition prevents vaccination, as recommended by the civil surgeon and approved by USCIS.
Should I prepare for the medical exam if my priority date is becoming current?
Yes. If your Form I-485 priority date is expected to be current soon, it is advisable to prepare for your immigration medical exam in advance.
How long is the immigration medical exam valid?
If Form I-693 is signed by a civil surgeon on or after November 1, 2023, it remains valid for as long as your green card application is pending.
Are X-rays required for pregnant applicants?
Pregnant applicants may postpone the chest X-ray until after delivery. However, they should consult with the Department of State (DOS) consular officer to confirm that the delay will not impact their immigration timeline.
How Green Card Link Can Help
The immigration medical exam is a critical step in the green card process, involving strict documentation, timing, and vaccination proof requirements. At Green Card Link, its immigration attorneys guide applicants through every stage — from scheduling the medical exam to preparing all required paperwork for a smooth and compliant application.