USCIS Medical Exam: What to Expect & How to Prepare for Your Immigration Physical

The USCIS medical exam is a crucial step for anyone applying for a green card (lawful permanent residency) in the United States. Conducted by a USCIS-designated civil surgeon, this exam ensures that applicants meet the health-related requirements set by U.S. immigration laws.

What is the USCIS Medical Exam?

The USCIS (United States Citizenship and Immigration Services) medical exam is a mandatory health screening required for all applicants seeking adjustment of status (Form I-485) to become a lawful permanent resident (green card holder).

This exam is not a standard physical check-up but a public health evaluation to ensure that applicants do not pose a risk to public safety due to certain medical conditions. The results of the exam are recorded on Form I-693, which must be submitted to USCIS.

Who Needs a USCIS Medical Exam?

The USCIS medical exam is required for:

• Green card applicants apply through family sponsorship, employment, asylum, or diversity lottery.
• Certain non-immigrant visa applicants, depending on specific health requirements.
• Refugees and asylum seekers adjusting their status to permanent residency.

If you are applying for a green card through consular processing, a similar medical examination is required, but it must be completed at a U.S. Department of State-approved physician in your home country.

What to Expect During the USCIS Medical Exam

The USCIS medical exam consists of several components, including:

1. Review of Medical History

The civil surgeon will ask about your past and current medical conditions, including:

• Chronic illnesses (e.g., diabetes, high blood pressure)
• Hospitalizations or surgeries
• Mental health history
• Drug or alcohol use

2. Physical Examination

A full-body physical exam will be conducted, including:

• Checking height, weight, and blood pressure
• Examining the heart, lungs, and abdomen
• Checking ears, eyes, nose, and throat
• Assessing overall physical and mental health

3. Vaccination Verification

USCIS requires applicants to be up-to-date on certain vaccinations to prevent the spread of infectious diseases. These may include:

• Measles, Mumps, Rubella (MMR)
• Hepatitis B
• Influenza
• Tetanus and Diphtheria (Tdap)
• Varicella (Chickenpox)
• COVID-19 (as per updated USCIS guidelines)

If you lack any required vaccinations, the doctor will administer them during your exam.

4. Tuberculosis (TB) Testing

• Applicants aged 2 and older must undergo a TB blood test (IGRA test).
• If the test is positive, further testing, such as a chest X-ray, may be required.

5. Syphilis and Gonorrhea Testing

• Applicants aged 15 and older are required to undergo blood tests for syphilis and gonorrhea.
• A urine test may also be conducted for gonorrhea screening.

6. Drug and Alcohol Screening

• The civil surgeon may ask about past or current drug and alcohol use.
• If there is a history of substance abuse, additional evaluations may be needed.

7. Mental and Behavioral Health Assessment

• The doctor will check for any mental health conditions that may impact eligibility, such as severe psychiatric disorders that pose a risk to others.

How to Prepare for the USCIS Medical Exam

Proper preparation can help ensure a smooth medical examination process.

1. Bring Required Documents

• Valid government-issued photo ID (passport, driver’s license, or birth certificate)
• Form I-693 (Report of Medical Examination and Vaccination Record) – some doctors may provide this form
• Vaccination records (translated if necessary)
• Medical history records (especially if you have chronic conditions or previous surgeries)
• List of current medications

2. Be Prepared for Additional Vaccinations

If you are missing any required vaccinations, be ready to receive them during the appointment.

3. Follow Pre-Test Instructions

• Some tests, like blood work for syphilis and gonorrhea, may require fasting. Check with the clinic beforehand.
• If you have a history of tuberculosis (TB), bring previous TB test results or chest X-rays.

4. Budget for the Exam

• The cost of the USCIS medical exam varies by location and provider, typically ranging from $200 to $500.
• Insurance may not cover the exam, so be prepared to pay out of pocket.

What Happens After the USCIS Medical Exam?

1. Doctor Completes Form I-693

Once your exam is completed, the doctor will fill out Form I-693 and seal it in an envelope. Do not open this envelope it must be submitted sealed to USCIS.

2. Submit Your Form I-693 to USCIS

• If you haven’t filed Form I-485 yet, submit Form I-693 along with your green card application.
• If you have already applied, you can mail Form I-693 to USCIS when requested or bring it to your green card interview.

3. Exam Results Validity

• The medical exam is valid for 2 years from the date the doctor signs Form I-693.

Common Reasons for Medical Exam Delays or Issues

1. Missing Vaccination Records – If you cannot prove prior vaccinations, you may need to receive additional shots.
2. Positive Tuberculosis Test – Requires a chest X-ray and possibly additional medical clearance.
3. Unsealed Form I-693 – USCIS will reject the form if the envelope is opened or altered.
4. Substance Abuse History – A history of drug abuse may require further medical evaluation.

Conclusion

The USCIS medical exam is a necessary step in the green card application process, ensuring that all applicants meet the required health standards. By understanding what to expect and preparing in advance, you can complete your medical exam efficiently and avoid unnecessary delays.