The immigration medical exam is a required part of the green card application process for individuals applying for permanent residency in the United States. Every applicant must complete the exam with a USCIS-designated civil surgeon before Form I-693 can be completed and submitted to U.S. Citizenship and Immigration Services (USCIS).
While the process may sound intimidating, most applicants complete the exam without any issues. The exam is designed to protect public health, verify vaccination status, and identify a limited number of medical conditions that may require additional review before a green card can be approved.
In this guide, we’ll break down exactly what happens during an immigration medical exam, the tests you’ll need, what documents to bring, and how to prepare for your appointment.
Quick Answer
The USCIS immigration medical exam consists of four required components:
- Medical history review
- Physical examination
- Required laboratory tests
- Vaccination review
A USCIS-designated civil surgeon completes these steps, records the findings on Form I-693, seals the completed form, and provides it for submission as part of your green card application.
Immigration Medical Exam Components at a Glance
| Component | Purpose |
| Medical History Review | Reviews past and current medical conditions, medications, surgeries, and health history |
| Physical Examination | Evaluates overall health and screens for signs of certain medical conditions |
| Laboratory Testing | Screens for tuberculosis, syphilis, HIV, and other required conditions |
| Vaccination Review | Confirms compliance with USCIS immunization requirements |
What Happens During an Immigration Medical Exam?
During an immigration medical exam, a USCIS-designated civil surgeon reviews your health history, performs a physical examination, orders required laboratory tests, and verifies your vaccination records. The results are documented on Form I-693 and become part of your green card application.
Most appointments take between 60 and 90 minutes, although additional testing or vaccinations may extend the process.
Why Does USCIS Require an Immigration Medical Exam?
USCIS requires immigration medical exams to help protect public health and ensure applicants meet the medical requirements established under U.S. immigration law.
The exam focuses on three primary areas:
- Screening for communicable diseases of public health significance
- Verifying compliance with vaccination requirements
- Evaluating specific physical or mental health conditions that may require additional review
Importantly, the immigration medical exam is not a general health screening or a test of overall fitness. Having common medical conditions does not automatically affect your immigration application.
Many applicants successfully complete the exam while managing conditions such as:
- Diabetes
- High blood pressure
- Asthma
- Depression
- Anxiety
- Thyroid disorders
The goal is to identify a specific set of conditions outlined by immigration law, not to determine whether someone is “healthy enough” to immigrate.
According to the official USCIS guidelines, the exam must be completed using the current version of Form I-693. You can review the latest requirements directly through the USCIS Form I-693 Instructions.
The 4 Required Components of an Immigration Medical Exam
Every immigration medical exam follows the same general process. While testing requirements may vary slightly based on age, medical history, or prior vaccination records, all applicants complete the same four core components.
Component #1: Medical History Review
The first step of the immigration medical exam is a detailed review of your medical history.
During this portion of the appointment, the civil surgeon asks questions about your health background and records the information on Form I-693. The goal is to identify any medical conditions that may require additional documentation, testing, or follow-up.
What Questions Will the Civil Surgeon Ask?
The medical history review typically includes questions about:
- Past medical diagnoses
- Hospitalizations and surgeries
- Mental health history
- Substance use history
- Current medications
- History of communicable diseases
- Previous treatments or ongoing medical care
You should answer all questions honestly and completely. Providing inaccurate information or omitting relevant medical history can create complications later in the immigration process.
How Long Does the Medical History Review Take?
For most applicants, this portion of the appointment takes approximately 10 to 20 minutes.
The exact time depends on your medical history and whether the civil surgeon needs to review additional records or ask follow-up questions.
What Should You Bring?
If you have a significant medical condition, bringing supporting documentation can help avoid delays.
Examples include:
- Surgical records
- Hospital discharge summaries
- Specialist reports
- Mental health treatment documentation
- Letters from treating physicians
- Medication lists
Having these records available helps the civil surgeon accurately document your condition and determine whether any additional evaluation is necessary.
Will Existing Medical Conditions Affect My Green Card?
One of the biggest concerns applicants have is whether a chronic medical condition will prevent them from receiving a green card.
In most cases, the answer is no.
Conditions such as diabetes, asthma, hypertension, depression, and many other common health conditions generally do not affect the outcome of your immigration medical exam.
The medical history review is focused on identifying a limited number of conditions defined under U.S. immigration law, not evaluating your overall health status.
As long as your condition is properly managed and does not fall into a category that requires additional review, it is unlikely to create issues during the immigration process.
Component #2: Physical Examination
After reviewing your medical history, the civil surgeon performs a complete physical examination.
This portion of the appointment typically takes between 15 and 30 minutes and helps identify any signs of communicable disease or medical conditions that may require further evaluation.
What Happens During the Physical Exam?
The examination is similar to a routine physical performed by a primary care physician.
The civil surgeon evaluates several body systems, including:
| Body System | What the Civil Surgeon Checks |
| Eyes | Vision and signs of communicable eye disease |
| Ears | Hearing and ear health |
| Nose and Throat | Airways, throat, and lymph nodes |
| Heart and Lungs | Heart sounds, breathing, and respiratory function |
| Abdomen | Tenderness and organ enlargement |
| Skin | Rashes, lesions, and signs of communicable conditions |
| Lymph Nodes | Signs of infection or disease |
| Neurological | Reflexes, coordination, and neurological function |
| Musculoskeletal | Range of motion and mobility |
The physical examination is generally straightforward and non-invasive.
What Should You Wear?
Wear comfortable clothing that allows the doctor to perform the examination efficiently.
You may be asked to change into a medical gown depending on the type of examination required.
Loose-fitting clothing often makes the process easier and more comfortable.
What Medical Records Should You Bring?
If you have a visible medical condition, surgical scar, implanted medical device, or other health concern that may raise questions during the exam, bring supporting medical records whenever possible.
Examples include:
- Pacemaker documentation
- Surgical records
- Skin condition diagnoses
- Specialist evaluations
- Ongoing treatment plans
Providing documentation during the appointment can help prevent unnecessary delays or requests for additional information.
In the next section, we’ll cover the laboratory tests required during the immigration medical exam, including tuberculosis screening, HIV testing, syphilis testing, and the differences between TB skin tests and blood tests.
Component #3: Required Laboratory Tests
Laboratory testing is a required part of every immigration medical exam. These tests help identify certain communicable diseases that USCIS considers important for public health purposes.
The exact tests required may vary based on your age, medical history, and any findings during the physical examination. However, most adult applicants will complete a standard group of laboratory screenings.
Standard Lab Tests for Most Adult Applicants
The civil surgeon will typically order the following tests:
| Lab Test | What It Screens For | Who Requires It |
| TB Skin Test (PPD) or TB Blood Test (IGRA) | Tuberculosis | All applicants |
| HIV Test | Human Immunodeficiency Virus | Applicants age 15 and older |
| Syphilis Test (RPR or VDRL) | Syphilis infection | Adult applicants |
| Gonorrhea Testing | Gonorrhea infection | When required by USCIS guidelines |
These tests are designed to identify specific conditions outlined in immigration regulations and are not intended to be a comprehensive health screening.
Additional Tests That May Be Required
In some situations, additional testing may be necessary.
| Situation | Additional Testing |
| Positive TB Test | Chest X-ray |
| Abnormal Physical Exam Findings | Additional evaluation |
| Clinical Concern Identified by Civil Surgeon | Further testing as needed |
Additional testing does not automatically indicate a problem with your application. In many cases, it is simply a precautionary step to gather more information.
TB Testing Explained: Skin Test vs. Blood Test
Tuberculosis (TB) screening is one of the most common areas of confusion for immigration applicants.
Most applicants will receive either:
- A TB skin test (PPD)
- A TB blood test (IGRA)
Both tests are used to screen for tuberculosis infection, but they differ in several important ways.
| Feature | Skin Test (PPD) | Blood Test (IGRA) |
| Visits Required | 2 visits | 1 visit |
| Results Available | 48-72 hours | 1-7 days |
| Affected by BCG Vaccine | Yes | No |
| Cost | Lower | Higher |
Which TB Test Is Better?
For applicants who received the BCG vaccine as children, the IGRA blood test is often preferred.
The BCG vaccine is commonly administered in countries throughout Asia, Latin America, Africa, and Europe. Because the vaccine can cause false-positive skin test results, the blood test is generally considered more accurate for many immigrants.
If your TB screening result is positive, the civil surgeon may order a chest X-ray to determine whether active tuberculosis is present.
A positive TB test does not automatically mean you have active tuberculosis or that your green card application will be denied.
Component #4: Vaccination Review
The final component of the immigration medical exam is a review of your vaccination history.
USCIS requires applicants to meet specific immunization requirements based on recommendations from the Advisory Committee on Immunization Practices (ACIP).
The civil surgeon reviews your records and determines whether additional vaccines or immunity testing may be required.
Required Vaccines for Immigration Medical Exams
Commonly required vaccines include:
| Vaccine | Standard Requirement |
| Influenza (Flu) | Annual vaccination during flu season |
| COVID-19 | Per current CDC and ACIP guidance |
| Tdap | Tetanus, Diphtheria, Pertussis |
| MMR | Measles, Mumps, Rubella |
| Varicella | Chickenpox |
| Hepatitis A | Age and risk based |
| Hepatitis B | Age and risk based |
| HPV | Based on age guidelines |
| Pneumococcal | Age-based requirement |
For current vaccine recommendations, applicants can review the official CDC Immunization Schedule.
What Happens If You’re Missing Vaccines?
Many applicants arrive without complete vaccination records.
If required vaccines are missing, the civil surgeon may:
- Administer the vaccines during the appointment
- Recommend a separate vaccination appointment
- Order blood titer testing to verify immunity when appropriate
This is one of the most common reasons immigration medical exam costs vary between patients.
Can Blood Titers Replace Vaccines?
In some situations, a blood titer test can be used instead of vaccination.
Titers measure antibodies in your blood and may demonstrate immunity from previous vaccination or infection.
Titers are commonly accepted for:
- MMR
- Varicella
- Hepatitis B
If immunity is confirmed through laboratory testing, additional vaccination may not be necessary.
Are Foreign Vaccination Records Accepted?
Yes.
Many applicants received vaccinations outside the United States, and foreign vaccination records are generally accepted.
Bring all available documentation, including:
- Childhood vaccination booklets
- School health records
- Government immunization records
- Physician vaccination records
Records in languages other than English may still be useful and should be brought to the appointment for review.
What Happens After the Immigration Medical Exam?
Once all four components are completed, the civil surgeon reviews the results and prepares your immigration medical paperwork.
The process typically follows these steps:
Step 1: Form I-693 Is Completed
The civil surgeon records the results of your medical history review, physical examination, laboratory testing, and vaccination review.
Step 2: Laboratory Results Are Reviewed
All required testing must be completed before the form can be finalized.
If additional testing is required, the civil surgeon will explain the next steps.
Step 3: Any Follow-Up Requirements Are Addressed
In some cases, treatment, additional documentation, or specialist evaluation may be required before the form can be completed.
Most applicants do not require additional follow-up.
Step 4: The Form Is Sealed
Once completed, Form I-693 is placed inside a sealed envelope.
The envelope must remain sealed for USCIS.
Step 5: Submit the Form to USCIS
You will receive the sealed packet and submit it according to USCIS instructions as part of your immigration case.
Important: Never Open the Sealed Envelope
One of the most important rules of the immigration medical process is that the sealed Form I-693 package must remain unopened.
Opening the envelope can invalidate the form and may require repeating the entire medical examination, including additional fees and testing.
If you are unsure where to submit the completed form, review the latest guidance from the USCIS Form I-693 Instructions.
For applicants preparing for their adjustment of status interview, our guide on Medical Exam for Green Card: What to Expect provides a detailed overview of the process from appointment to approval.
What Can Affect a Green Card Application?
One of the most common concerns applicants have is whether a medical condition will prevent them from receiving a green card.
The good news is that most health conditions do not affect immigration eligibility. Conditions such as diabetes, asthma, high blood pressure, anxiety, and depression generally do not create issues during the immigration medical exam.
However, USCIS does identify a limited number of medical conditions that may require additional evaluation or treatment before an application can move forward.
Medical Conditions That May Require Additional Review
| Category | Examples | What Happens |
| Communicable Diseases of Public Health Significance | Active tuberculosis, untreated syphilis, untreated gonorrhea | Treatment may be required before the case proceeds |
| Missing Required Vaccinations | Missing vaccines without an approved exemption | Vaccinations may be required before completion |
| Physical or Mental Disorders Associated With Harmful Behavior | Conditions posing a direct threat to others | Additional evaluation may be required |
| Drug Abuse or Addiction | Current substance use disorder | Further medical review may be necessary |
It is important to remember that even if a condition is identified during the exam, it rarely results in a permanent denial. Many conditions can be treated, documented, waived, or re-evaluated depending on the circumstances.
If you have concerns about a medical condition, discuss them with your civil surgeon before the appointment.
How Long Does an Immigration Medical Exam Take?
Most immigration medical exam appointments take between 60 and 90 minutes.
The exact timing depends on your medical history, vaccination status, and whether additional testing is required.
Typical Appointment Timeline
| Step | Estimated Time |
| Check-In and Paperwork | 10-15 Minutes |
| Medical History Review | 10-20 Minutes |
| Physical Examination | 15-30 Minutes |
| Laboratory Testing | 10-15 Minutes |
| Vaccination Review | 10-30 Minutes |
| Form Completion | 10-15 Minutes |
Total Estimated Appointment Time: 60-90 Minutes
If multiple vaccinations are needed, additional time may be required.
Applicants who receive a TB skin test instead of a blood test may also need to return 48 to 72 hours later so the test can be read and documented.
For a full breakdown of costs and testing requirements, see our guide to Immigration Medical Exam Cost.
Immigration Medical Exam Checklist
Preparing in advance can help prevent delays and reduce the chances of needing a second appointment.
Bring These Items to Your Appointment
✓ Government-issued photo ID (passport, state ID, or driver’s license)
✓ All available vaccination records
✓ Medical records for chronic conditions, surgeries, or hospitalizations
✓ Current medication list
✓ Insurance card (if applicable)
✓ Payment method accepted by the clinic
Additional Documents That May Be Helpful
✓ Mental health treatment records
✓ Specialist reports
✓ Surgical records
✓ Documentation for implanted medical devices
✓ Foreign vaccination booklets
Bringing complete records often helps avoid unnecessary vaccinations and additional testing.
How to Prepare for Your Immigration Medical Exam
A little preparation can make your appointment smoother and help avoid unexpected delays.
Gather Vaccination Records Before Your Appointment
Vaccination records are one of the most important parts of the immigration medical exam.
If you were vaccinated outside the United States, gather all available records before your appointment. Even partial records may help the civil surgeon determine what vaccines or titers are needed.
Bring Supporting Medical Documentation
If you have a chronic condition or prior surgery, bring documentation whenever possible.
Having records available allows the civil surgeon to accurately complete Form I-693 and reduces the likelihood of additional follow-up requests.
Be Honest During the Medical History Review
The immigration medical exam is not designed to disqualify applicants for common health conditions.
Providing accurate information helps ensure the process goes smoothly and avoids future complications.
Plan for Additional Vaccinations If Needed
If your records are incomplete, you may need vaccines during your appointment.
Some applicants choose to receive missing vaccines before their immigration medical exam and bring documentation to the appointment.
You can learn more about immunization requirements in our guide to What Vaccines Are Required for the Immigration Medical Exam?
Getting an Immigration Medical Exam in Brooklyn, NY
If you are applying for a green card in Brooklyn, choosing an experienced USCIS-designated civil surgeon can make the process easier and less stressful.
At Weibo Medical Care, we perform immigration medical exams for green card applicants throughout Brooklyn and the surrounding communities.
Why Patients Choose Weibo Medical Care
Our team takes extra time to help patients understand the immigration medical process and complete Form I-693 accurately.
We help patients by:
- Reviewing foreign vaccination records before recommending additional vaccines
- Explaining every step of the examination process
- Answering questions about USCIS requirements
- Helping applicants understand what documentation may be needed
Languages We Support
We provide immigration medical exams in:
- English
- Mandarin
- Spanish
This is especially helpful for applicants bringing foreign medical records or vaccination documentation.
Schedule Your Immigration Medical Exam
Weibo Medical Care
849 53rd Street, 7th Floor
Brooklyn, NY 11220
Hours:
Monday through Sunday
9:00 AM to 5:00 PM
If you’re looking for an immigration medical exam in Brooklyn, our team is available to help guide you through the process from start to finish.
Frequently Asked Questions
What is the most important part of the immigration medical exam?
All four components are required, but the vaccination review often causes the most delays. Bringing complete vaccination records can help avoid unnecessary vaccines, additional testing, and unexpected costs.
Does the civil surgeon share my medical exam results with anyone other than USCIS?
No. Form I-693 is completed for immigration purposes and submitted only to USCIS. Your results are not shared with employers, insurance companies, or other government agencies.
What happens if my TB test comes back positive?
A positive TB test does not automatically mean you have active tuberculosis. The civil surgeon will typically order a chest X-ray and may recommend additional evaluation. Many applicants with positive tests do not have active TB disease.
Can I complete the immigration medical exam before filing Form I-485?
Yes. Many applicants complete the exam before filing Form I-485. However, because Form I-693 has a limited validity period, it is generally best to complete the exam close to your filing date.
Do I need to fast before the immigration medical exam?
No. Standard immigration medical exam testing does not require fasting.
What if I have a documented vaccine allergy or medical exemption?
The civil surgeon can document a qualifying medical exemption on Form I-693. Supporting documentation from your treating physician may be required.
Can a child have a different immigration medical exam than an adult?
Yes. Children may have different testing and vaccination requirements based on their age and medical history.
Is the immigration medical exam the same as a visa medical exam?
Not exactly. Applicants adjusting status inside the United States use Form I-693 completed by a USCIS-designated civil surgeon. Applicants applying through consular processing abroad use a panel physician designated by a U.S. embassy or consulate.
Related Resources
Internal Links
- Immigration Medical Exam Cost
- Medical Exam for Green Card: What to Expect
- What Vaccines Are Required for the Immigration Medical Exam?
- USCIS Immigration Medical Exam Service Page
Helpful External Resources
Final Thoughts
The immigration medical exam is a straightforward process that consists of four primary components: a medical history review, physical examination, laboratory testing, and vaccination review. Most applicants complete the process in a single visit and receive a sealed Form I-693 for submission to USCIS.
Preparing ahead of time by gathering vaccination records, medical documentation, and identification can help make the appointment smoother and reduce the likelihood of delays. By understanding what to expect before your appointment, you can approach the immigration medical exam with confidence and move one step closer to completing your green card application.