If you are applying for a green card or adjusting your immigration status in the United States, you will likely need to complete an immigration physical, officially called the USCIS medical examination. This exam is performed by a USCIS-authorized civil surgeon and is required for most applicants seeking permanent residency.
Understanding the process can help you avoid delays, reduce stress, and ensure your application is complete. This guide explains what happens during immigration physicals, what documents to bring, how much the exam costs, vaccine requirements, and common mistakes applicants should avoid.
What Is an Immigration Physical?
An immigration physical is a medical examination required by U.S. Citizenship and Immigration Services (USCIS) to determine whether an applicant has any health-related conditions that could make them inadmissible to the United States.
The exam is documented on Form I-693, Report of Immigration Medical Examination and Vaccination Record. Only a doctor designated by USCIS as a civil surgeon can complete and sign this form.
Why USCIS Requires the Exam
The medical exam helps USCIS identify:
- Communicable diseases of public health significance
- Missing required vaccinations
- Physical or mental disorders associated with harmful behavior
- Drug abuse or addiction
The goal is to protect public health while ensuring applicants meet immigration requirements.
Who Needs an Immigration Medical Exam?
You generally need immigration physicals if you are:
- Applying for a green card (permanent residence)
- Filing Form I-485 (Adjustment of Status)
- Applying for certain immigrant visas through a U.S. consulate
You may not need a new exam if:
- You already submitted a valid Form I-693
- Your previous exam is still within USCIS validity rules
- USCIS specifically waives the requirement in your case
How to Find a USCIS Civil Surgeon
USCIS maintains an official directory of authorized civil surgeons.
Steps to Find a Civil Surgeon
- Visit the USCIS Civil Surgeon locator.
- Enter your ZIP code or city.
- Review the list of authorized doctors.
- Call the office to confirm they still perform immigration physicals.
- Ask about pricing and appointment availability.
Questions to Ask Before Booking
- What is the total cost of the exam?
- Are laboratory tests included?
- Are vaccines included?
- How long does it take to receive the sealed Form I-693?
- Do you offer same-day or next-day appointments?
Searching for “immigration physicals near me” can help you find nearby clinics, but always verify that the doctor is listed in the official USCIS directory.
Documents You Must Bring
Bring the following items to your appointment:
| Document | Required? |
|---|---|
| Government-issued photo ID | |
| Passport | |
| Vaccination records | |
| Form I-693 (if requested by clinic) | |
| Medical records for chronic conditions | |
| List of current medications |
Vaccination Records
If you have vaccination records from another country, bring the original documents and certified English translations if they are not in English.
What Happens During the Exam?
The immigration physical is usually straightforward and takes 30–90 minutes.
Medical History Review
The doctor will ask about:
- Past illnesses and surgeries
- Hospitalizations
- Mental health history
- Substance use
- Current medications
- Previous tuberculosis treatment
Physical Examination
The doctor will check:
- Height and weight
- Blood pressure
- Heart and lungs
- Vision and general physical condition
- Abdomen and other body systems
Laboratory Tests
Most applicants must complete:
- Tuberculosis (TB) screening
- Syphilis blood test
- Gonorrhea test
Additional tests may be ordered if medically necessary.
Vaccine Requirements
USCIS requires applicants to receive age-appropriate vaccines recommended by the Centers for Disease Control and Prevention (CDC).
Common Required Vaccines
- Measles, Mumps, and Rubella (MMR)
- Tetanus and Diphtheria (Td/Tdap)
- Varicella (chickenpox)
- Polio
- Hepatitis B
- Influenza (during flu season)
- COVID-19 (if required under current CDC guidance)
If you are missing vaccines, the civil surgeon may administer them during the appointment or refer you to another provider.
How Much Do Immigration Physicals Cost?
Costs vary by state and clinic.
Estimated 2026 cost range
Basic immigration physical exam
$150–$400
Laboratory tests
$50–$150
Vaccinations
$20–$200+
Total estimated cost
$200–$700+
Always ask for a written price quote before your appointment.
Some clinics advertise “fast immigration physicals” or “same-day immigration medical exams.” These services may cost more but can be useful if you have an upcoming USCIS interview.
How Long Does It Take to Get Form I-693?
After the exam, the civil surgeon completes Form I-693 and places it in a sealed envelope.
Important: Do Not Open the Envelope
USCIS will reject the form if the sealed envelope has been opened.
Typical Processing Times
- Same day: Some clinics
- 2–7 business days: Most clinics
- Longer: If additional test results are pending
Ask the clinic when the sealed packet will be ready for pickup.
Common Reasons for Delays
Missing Vaccination Records
This is the most common issue. If you cannot prove prior vaccinations, you may need additional shots.
Positive TB Test
A positive TB blood test does not automatically disqualify you. You may need a chest X-ray and further evaluation.
Incomplete Medical History
Bring records for conditions such as:
- Diabetes
- High blood pressure
- Heart disease
- Previous TB treatment
- Mental health treatment
Expired Form I-693
USCIS has specific validity rules for Form I-693. Submit it within the required timeframe.
Tips to Prepare for Your Immigration Physical
Before the Appointment
- Gather vaccination records.
- Bring your passport and ID.
- Make a list of medications.
- Get enough sleep the night before.
- Drink water and eat normally unless the clinic gives special instructions.
During the Appointment
- Answer questions honestly.
- Ask for clarification if you do not understand something.
- Request copies of any vaccination records provided.
- Confirm when the sealed I-693 packet will be ready.
Can You Fail an Immigration Physical?
Most applicants do not fail the exam. However, certain conditions can affect admissibility.
Possible Grounds of Inadmissibility
- Active tuberculosis
- Untreated syphilis
- Certain communicable diseases
- Drug abuse or addiction
- Mental disorders associated with harmful behavior
In many cases, treatment or additional documentation can resolve the issue.
Immigration Physicals for Families
Each family member generally needs a separate exam.
Children
Children may need fewer laboratory tests depending on age, but vaccination requirements still apply.
Pregnant Applicants
Pregnant applicants should inform the civil surgeon. Some vaccines may be postponed, and alternative TB screening methods may be used.
What Happens After You Submit Form I-693?
USCIS will review the sealed medical packet as part of your green card application.
Possible outcomes:
- Accepted: No further action needed.
- Request for Evidence (RFE): USCIS needs additional information.
- Interview Questions: The officer may ask about vaccinations or medical history.
Keep copies of your vaccination records and any receipts for your personal files.
Frequently Asked Questions
How long are immigration physicals valid?
USCIS validity rules can change, but Form I-693 is generally valid for a limited period after the civil surgeon signs it.
Can I use my regular doctor?
No. The exam must be performed by a USCIS-authorized civil surgeon.
Do I need health insurance?
Health insurance is not required for the exam, but it may help cover some vaccines.
Can I get the exam before filing Form I-485?
Yes. Many applicants complete the exam in advance, but be mindful of the form’s validity period.
What if I lost my vaccination records?
The doctor may perform blood tests to check immunity or administer the required vaccines again.
Final Thoughts
Completing your immigration physical is an important step in the green card process. By finding a qualified civil surgeon, bringing the correct documents, and understanding the vaccine and testing requirements, you can avoid unnecessary delays and keep your application moving forward.
For the most accurate and up-to-date information, always check the official USCIS and CDC guidance before your appointment.
