TL;DR
- The immigration medical exam is Form I-693 completed in the U.S. by a USCIS-designated civil surgeon to confirm you meet health and vaccination requirements for a green card. Your doctor gives you a sealed envelope for USCIS and a copy for your records—do not open the sealed packet. (USCIS)
- Required elements include TB blood testing (IGRA) for ages 2+, syphilis and gonorrhea testing (age-based), a vaccination review/updates, plus a physical and mental health assessment following CDC Technical Instructions. (CDC)
- Since June 11, 2025, USCIS ties I-693 validity to your pending I-485: if that application is withdrawn/denied, you’ll need a new I-693 for any future filing. (USCIS)
Table of contents
- What exactly is Form I-693 (and why USCIS requires it)
- Who can perform the exam (civil surgeon vs. panel physician)
- What’s included in the immigration medical
- Step-by-step: how your appointment works
- Cost basics (why prices differ)
- Validity, sealed packets, and common mistakes
- FAQs
- Sources (USCIS/CDC)
1) What exactly is Form I-693 (and why USCIS requires it)
Form I-693, Report of Medical Examination and Vaccination Record, documents that you are not inadmissible on health-related grounds and that you meet required vaccinations for adjustment of status. In the U.S., only a USCIS-designated civil surgeon may complete it; you submit the sealed original to USCIS and keep a copy. (USCIS)
Keywords woven: Immigration Medical Exam, I-693 Immigration Medical Exam, USCIS Civil Surgeon, USCIS Approved Doctors.
2) Who can perform the exam (civil surgeon vs. panel physician)
- Inside the U.S.: You must use a USCIS-designated civil surgeon. Use USCIS’s official Find a Civil Surgeon locator to search by ZIP code. (USCIS)
- Outside the U.S.: Exams are done by panel physicians under Department of State rules (similar, but separate instructions). (This article focuses on civil surgeons in the U.S.) (CDC)
Keywords touched: Find Immigration Doctor, USCIS Doctor Locator, Immigration Surgeon Locator, USCIS Designated Doctor.
3) What’s included in the immigration medical
A) Tuberculosis (TB) screening
Civil surgeons must follow CDC’s TB Technical Instructions. IGRA blood testing is required for applicants age 2 and older, with additional evaluation (e.g., chest X-ray, treatment/referral) if indicated by results or symptoms. (CDC)
B) Syphilis testing
CDC instructions require syphilis testing for ages 18 to <45; test younger or older applicants if there’s reason to suspect infection. Results are recorded on I-693 using accepted algorithms. (CDC)
C) Gonorrhea testing
CDC instructions require gonorrhea testing for ages 18–24; others are tested if indicated. Importantly, the NAAT must be ordered by the civil surgeon at the time of the immigration exam—outside results aren’t accepted. (CDC)
D) Vaccination review & updates
The civil surgeon verifies that you meet immigration vaccination requirements (age-appropriate immunizations such as MMR, varicella, Tdap, polio, hepatitis B, influenza in season, etc.). CDC instructs civil surgeons to complete the I-693 and give you a sealed envelope for USCIS plus a copy for your records. Bring written vaccine records; self-reported doses don’t count. (CDC)
E) Physical & mental health assessment
Beyond labs and vaccines, the civil surgeon performs a medical history and physical exam, and evaluates for conditions relevant to immigration law (communicable diseases of public health significance; certain physical or mental disorders with associated harmful behavior; and substance-related disorders). Findings are recorded on I-693 for USCIS review. (CDC)
Keywords woven: Immigration Medical Exam Blood Test, Immigration Vaccination, Immigration Exam Doctor, USCIS Medical Examination Doctors, I-693 Medical Examination Doctors.
4) Step-by-step: how your appointment works
- Find and book a civil surgeon. Start with USCIS’s Find a Civil Surgeon tool to confirm designation, then use EasyIME to compare civil surgeons by price & availability and pick your Green Card exam doctor. Bring photo ID and vaccination records. (USCIS)
- History & physical. The doctor reviews your medical history, performs a head-to-toe exam and mental health screening, and orders required tests (TB, syphilis, gonorrhea per age/indication). (CDC)
- Vaccination updates. Any missing immigration-required vaccines are administered (or referred) and documented per CDC guidance. (CDC)
- Form completion & sealing. When results are back, the civil surgeon completes Form I-693, gives you a copy, and provides the official sealed envelope. Do not open it—USCIS accepts only the sealed original. (USCIS)
CTA: Compare civil surgeons by price & availability → Book now (internal links to your “Find An Immigration Doctor” flow)
5) Cost basics (why prices differ)
There’s no USCIS fee for the medical exam; clinics set their own prices. Your total typically includes: (1) the exam visit, (2) required labs (TB, syphilis, gonorrhea when applicable), and (3) any vaccines you need. That’s why shopping for the cheapest immigration medical exam that still meets CDC/USCIS rules is smart. (USCIS)
Keywords touched: Cheapest immigration medical exam, USCIS Approved Doctors for Medical Exam, Find USCIS Doctors.
6) Validity, sealed packets, and common mistakes
- Validity: As of June 11, 2025, USCIS policy clarifies that I-693 is tied to the pending I-485; if your I-485 is withdrawn/denied, you’ll need a new I-693 for a future filing. (USCIS)
- Sealed envelope: USCIS won’t accept I-693 unless it’s sealed and unaltered; you should also receive a copy for your records. (USCIS)
- Using a non-designated doctor: Inside the U.S., you must see a USCIS-designated civil surgeon (not just any clinic). Use the official locator before you book. (USCIS)
- Relying on outside gonorrhea results: CDC requires the NAAT be ordered during the exam by the civil surgeon—outside results aren’t acceptable. (CDC)
FAQs
Is the immigration medical exam the same as a regular physical?
No. It’s a standardized immigration exam under CDC Technical Instructions that focuses on communicable diseases, specific screenings (TB, syphilis, gonorrhea), and vaccination compliance—not general wellness labs. (CDC)
Do children need TB testing?
Yes. IGRA TB testing is required for applicants age 2 and older, with follow-up as indicated by results or symptoms. (CDC)
Who must be tested for syphilis and gonorrhea?
- Syphilis: test ages 18 to <45; others if there’s reason to suspect infection. (CDC)
- Gonorrhea: test ages 18–24; others if indicated; NAAT must be ordered by the civil surgeon at the time of exam. (CDC)
How much does it cost?
USCIS doesn’t set a fee; clinics do. Pricing depends on exam visit, lab panels, and any vaccines needed—so it pays to compare immigration exam clinics before booking. (USCIS)
How long is my I-693 valid?
Under USCIS’s June 11, 2025 policy update, the I-693 is generally valid only while your related I-485 is pending. If that application is withdrawn/denied, expect to submit a new I-693 for a future filing. (USCIS)
Clear next steps
- Find USCIS-approved doctors: Use USCIS’s Find a Civil Surgeon tool, then compare civil surgeons by price & availability on EasyIME to pick your Green Card medical doctor. (USCIS)
- Book now: Bring photo ID and vaccination records; follow clinic instructions for labs and return visits, and don’t open the sealed packet.
CTA: Compare civil surgeons by price & availability → Book now
Sources (USCIS/CDC)
- USCIS — Form I-693 overview. (USCIS)
- USCIS — I-693 Instructions (sealed envelope; copy to applicant). (USCIS)
- USCIS — Find a Civil Surgeon (official locator). (USCIS)
- USCIS — Finding a Medical Doctor (process; sealing). (USCIS)
- USCIS — Policy Alert (June 11, 2025): I-693 validity. (USCIS)
- CDC — Technical Instructions for Civil Surgeons (scope). (CDC)
- CDC — TB TI (IGRA for ages 2+). (CDC)
- CDC — Syphilis TI (age-based testing). (CDC)
- CDC — Gonorrhea TI (age-based testing; NAAT ordered at exam). (CDC)
- CDC — Vaccination TI + Age-based table (sealing instructions; required vaccines). (CDC)
