What is tested in the immigration medical exam?

TL;DR 

• The immigration medical exam (Form I-693) checks for TB, syphilis, and gonorrhea (age-based), reviews vaccinations, and includes a physical and mental health assessment—all performed by a USCIS-designated civil surgeon in the U.S. (USCIS) 

• After results are ready, the doctor completes Form I-693, gives you a sealed envelope for USCIS, and a copy for your records. Do not open the sealed packet. (CDC) 

• Prices vary by clinic because USCIS does not set exam fees—compare clinics to find the cheapest immigration medical exam that meets CDC/USCIS rules. (Use EasyIME to compare.) (USCIS) 

Table of contents 

Table of contents 

1. What exactly is “tested” in the immigration medical? 

2. TB testing (who gets tested and what happens next) 

3. Syphilis testing (who must be tested) 

4. Gonorrhea testing (who must be tested and how it’s ordered) 

5. Vaccination review (what counts, what doesn’t) 

6. Physical and mental health assessment 

7. What’s not universally tested 

8. Step-by-step: how your appointment plays out 

9. FAQs 

10. Sources (USCIS/CDC) 

1) What exactly is “tested” in the immigration medical? 

Inside the U.S., the I-693 immigration medical exam documents that you’re not inadmissible on health grounds and that you meet vaccination requirements. A USCIS-designated civil surgeon performs the exam, orders required tests, and records results on Form I-693. (USCIS) 

Keywords woven naturally: Immigration Medical Exam, I-693 Immigration Medical Exam, USCIS Civil Surgeon, USCIS Approved Doctors, USCIS Doctor Locator. 

2) TB testing (who gets tested and what happens next) 

Civil surgeons must follow CDC TB Technical Instructions. An IGRA blood test is required for applicants age 2 and older, with additional evaluation (for example, chest X-ray, treatment/referral) if indicated by results or symptoms. Local reporting and follow-up are guided by CDC/state health departments. (CDC) 

What this means for you: expect a blood draw if you’re 2+ years old; if results suggest infection or disease—or you have symptoms—you may need further imaging or follow-up before the I-693 can be finalized. (CDC) 

Keywords touched: Immigration Medical Exam Blood Test, I-693 Medical Exam, USCIS Medical Examination Doctors. 

3) Syphilis testing (who must be tested) 

CDC’s civil-surgeon guidance: test all applicants aged 18 to <45 for syphilis; test younger or older applicants if there’s reason to suspect infection. Results are documented on I-693 using accepted algorithms. (CDC) 

4) Gonorrhea testing (who must be tested and how it’s ordered) 

CDC’s civil-surgeon guidance: test all applicants aged 18–24 for gonorrhea; test younger or older applicants if clinically indicated. The test is a NAAT (e.g., urine or swab). For immigration purposes, testing is tied to the exam itself—it must be ordered during the exam under CDC instructions (panel-physician page makes this explicit and mirrors the civil-surgeon practice). (CDC) 

Practical note: Clinics generally cannot accept prior outside gonorrhea results in place of the exam-ordered test. (CDC) 

5) Vaccination review (what counts, what doesn’t) 

The civil surgeon must ensure you meet immigration vaccination requirements (age-appropriate vaccines such as MMR, varicella, Tdap, polio, hepatitis B, influenza in season, and others depending on age/history). The CDC’s vaccination Technical Instructions and age-based table guide what’s required and when. The civil surgeon should review written records, administer needed doses or document valid reasons (e.g., not medically appropriate), then complete and seal your I-693 and provide you a copy. (CDC) 

Bring documentation: self-reported vaccines without written proof do not count; official records (with dates) help you avoid unnecessary doses. (CDC) 

Keywords woven: Immigration Vaccination, Medical Examination for Green Card, USCIS Designated Medical Doctors. 

6) Physical and mental health assessment 

Beyond labs and vaccines, civil surgeons perform a medical history and physical exam and a mental health assessment to identify issues 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 Form I-693; USCIS officers then review the documentation as part of your case. (CDC) 

7) What’s not universally tested 

There is no across-the-board drug screen or mandatory pregnancy test for every applicant. Instead, civil surgeons order additional testing when medically indicated based on the CDC Technical Instructions and the clinical exam. (Individual clinics may have their own medical protocols in specific scenarios, but immigration rules do not require universal testing.) (CDC) 

8) Step-by-step: how your appointment plays out 

1. Find and book a civil surgeon. Use USCIS’s Designated Civil Surgeons page (official locator) to find USCIS authorized doctors. Then use EasyIME to compare civil surgeons by price & availability to pick your Green Card exam doctor and avoid surprise add-ons. (USCIS) 

2. History & physical. The doctor reviews your records (bring photo ID and vaccination records), performs a head-to-toe exam and mental health review, and orders the required TB, syphilis, and gonorrhea tests based on your age/indications. (CDC) 

3. Vaccination updates. Any missing immigration-required vaccines are administered (or referred) and recorded per CDC guidance and the age-based table. (CDC) 

4. Sealed results. After labs are back, the civil surgeon completes Form I-693, gives you a copy, and provides the sealed envelope for USCIS. Do not open the packet; submit the sealed original with your filing or RFE response. (CDC) 

CTA: Compare civil surgeons by price & availability → Book now (link to your “Find An Immigration Doctor” flow) 

FAQs 

Which tests are always part of the immigration medical? 
TB screening (IGRA for ages 2+), syphilis and gonorrhea testing by age/indication, plus a vaccination review; all are documented on Form I-693 by a USCIS-designated civil surgeon. (CDC) 

Do children need TB testing? 
Yes. IGRA is required for applicants age 2 and older, with further steps based on results/symptoms per CDC TB Technical Instructions. (CDC) 

Who must be tested for syphilis and gonorrhea? 

• Syphilis: 18 to <45 (others if there’s reason to suspect infection). (CDC) 

• Gonorrhea: 18–24 (others if indicated). Testing is NAAT and is tied to the exam. (CDC) 

Can outside lab results replace exam-ordered tests? 
For gonorrhea, immigration rules require the test to be ordered at the time of the exam—outside results aren’t acceptable substitutes. (CDC) 

How do I submit my results? 
Your civil surgeon will give you a sealed I-693 for USCIS and a copy for your files. Submit the sealed original; don’t open it. (CDC) 

Clear next steps 

• Find USCIS-approved doctors: Start at USCIS’s Designated Civil Surgeons page. Then compare civil surgeons by price & availability on EasyIME to select the right civil surgeon at the right price. (USCIS) 

• Book now: Bring photo ID and vaccination records. Ask what the quote includes (exam, labs, vaccines) so your budget matches your final bill. 

CTA: Compare civil surgeons by price & availability → Book now 

Sources (USCIS/CDC) 

• USCIS — Form I-693 page (what the exam is; health-grounds purpose). (USCIS) 

• CDC — TB Technical Instructions for Civil Surgeons (IGRA 2+; follow-up rules). (CDC) 

• CDC — Syphilis Technical Instructions for Civil Surgeons (age-based testing; I-693 recording). (CDC) 

• CDC — Gonorrhea Technical Instructions for Civil Surgeons (age-based testing; clinical notes). (CDC) 

• CDC — Gonorrhea Technical Instructions for Panel Physicians (explicit rule that NAAT must be ordered at the exam; illustrates immigration practice). (CDC) 

• CDC — Vaccination Technical Instructions for Civil Surgeons (requirements; “give sealed I-693 and a copy to the applicant”). (CDC) 

• CDC — Age-based vaccination table (PDF) for civil surgeons. (CDC) 

• USCIS Policy Manual — Review of Medical Examination Documentation (how officers review I-693). (USCIS) 

• USCIS — Designated Civil Surgeons (locator; civil-surgeon responsibilities). (USCIS)