What is the medical exam for a green card? 

TL;DR 

• The green card medical exam is the Form I-693 examination completed inside the U.S. by a USCIS-designated civil surgeon to confirm you meet immigration health and vaccination requirements. The doctor gives you a sealed envelope for USCIS and a copy for your records. (USCIS) 

• Required elements include TB screening (IGRA blood test for ages 2+), syphilis and gonorrhea testing by age, a vaccination review/updates, plus a physical and mental health assessment following CDC Technical Instructions. (CDC) 

• USCIS doesn’t set the price—clinics do—so it’s smart to compare immigration exam doctors to find the cheapest immigration medical exam that fits your timeline. (USCIS) 

Table of contents 

1. What exactly is the I-693 immigration medical exam? 

2. Who can perform it (civil surgeon vs. panel physician)? 

3. What does the exam include (tests & vaccines)? 

4. Step-by-step: how the appointment works 

5. Cost basics (why prices vary) 

6. How to submit your results to USCIS 

7. Common mistakes to avoid 

8. FAQs 

9. Sources (USCIS/CDC) 

1) What exactly is the I-693 immigration medical exam? 

Form I-693, Report of Medical Examination and Vaccination Record documents that you are not inadmissible on health-related grounds and that you meet vaccination requirements for adjustment of status (green card) in the U.S. Only a USCIS-designated civil surgeon may complete this exam domestically. The civil surgeon fills out the I-693, hands you a sealed envelope for USCIS, and provides your copy. Do not open the sealed packet. (USCIS) 

Keywords woven naturally: USCIS Civil Surgeon, USCIS Approved Doctors, Immigration Medical Exam, Green Card Medical Examination, I-693 Medical Exam. 

2) Who can perform it (civil surgeon vs. panel physician)? 

• Inside the U.S.: Exams must be performed by a USCIS-designated civil surgeon. You can find one via the USCIS Civil Surgeon Locator. (USCIS) 

• Outside the U.S.: Exams are completed by panel physicians under Department of State rules; the requirements are similar but follow DOS/CDC guidance for applicants abroad. (CDC) 

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3) What does the exam include (tests & vaccines)? 

A) Tuberculosis (TB) screening 

Civil surgeons must use an IGRA blood test for applicants age 2 and older, with next steps (e.g., chest X-ray, evaluation, treatment/referral) based on results and clinical judgment under CDC TB Technical Instructions. (CDC) 

B) Syphilis testing 

CDC instructions require syphilis testing for applicants aged 18 to <45; test younger or older applicants if clinically indicated (reason to suspect infection). (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.). The surgeon documents valid reasons if a vaccine is not medically appropriate (e.g., too young/old, contraindicated, not flu season). CDC confirms that applicants receive one dose as required during the immigration exam when series completion isn’t possible at that visit. (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), documenting findings on I-693. (CDC) 

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4) Step-by-step: how the appointment works 

1. Find and book a civil surgeon. Use USCIS’s Find a Civil Surgeon tool to locate USCIS authorized doctors, then use EasyIME to compare civil surgeons by price & availability and pick your Green Card exam doctor. Bring government-issued photo ID and any vaccination records. (USCIS) 

2. History & physical exam. The doctor reviews your health history, performs a head-to-toe exam, and evaluates mental health as required for immigration purposes. (CDC) 

3. Required tests & vaccines. The civil surgeon orders the IGRA TB test (age-based), syphilis, gonorrhea (NAAT) per age/indication, and updates vaccines as needed. (CDC) 

4. Sealed results. After results return, the civil surgeon completes Form I-693, gives you a copy, and provides the sealed envelope for USCIS. Do not open the sealed packet. (USCIS) 

CTA: Compare civil surgeons by price & availability → Book now (internal links). 

5) Cost basics (why prices vary) 

There is no USCIS fee for the medical exam itself. Clinics set their own prices, which vary based on the office fee, required lab panels, and vaccines you need. USCIS directs applicants to find a civil surgeon and compare fees—so it pays to shop for the cheapest immigration medical exam that still follows CDC/USCIS rules. (USCIS) There is no USCIS fee for the medical exam itself. Clinics set their own prices, which vary based on the office fee, required lab panels, and vaccines you need. USCIS directs applicants to find a civil surgeon and compare fees—so it pays to shop for the cheapest immigration medical exam that still follows CDC/USCIS rules. (USCIS) 

6) How to submit your results to USCIS 

• Submit the sealed I-693 with your I-485 (or in response to an RFE). USCIS requires the original sealed envelope (packets that are opened or altered are not accepted); you should keep your personal copy. (USCIS) 

• Validity policy (updated). As of June 11, 2025, USCIS clarifies that the I-693 is generally valid only for the specific immigration application it was submitted with (for example, your I-485) and only while that application remains pending; if it’s withdrawn or denied, a new I-693 is required for future filings. (USCIS) 

7) Common mistakes to avoid 

• Seeing a non-designated doctor. Inside the U.S., you must use a USCIS-designated civil surgeon—not a regular family physician. (USCIS) 

• Not bringing records. Missing vaccination records can lead to extra visits/costs; bring what you have. (CDC) 

• Relying on outside gonorrhea results. CDC requires the civil surgeon to order a NAAT at the time of exam; prior outside results aren’t accepted. (CDC) 

• Opening the sealed envelope. USCIS requires the sealed original; keep your copy separate. (USCIS) 

FAQs 

Is the green card medical exam the same as a regular physical? 
No. It’s a standardized exam under CDC Technical Instructions to assess immigration-specific health grounds and vaccination status—not a general wellness visit. (CDC) 

Do children need TB screening? 
Yes. IGRA TB testing is required for applicants age 2 and older (with follow-up per results/symptoms). (CDC) 

Who must be tested for syphilis and gonorrhea? 

• Syphilis: test ages 18 to <45; others if indicated. (CDC) 

• Gonorrhea: test ages 18–24; others if indicated; NAAT must be ordered by the civil surgeon at the time of the exam. (CDC) 

Can I get vaccines during the appointment? 
Often yes. The civil surgeon ensures you meet immigration vaccination requirements and can administer missing doses or refer you. (CDC) 

How much does the immigration medical exam cost? 
USCIS doesn’t set a fee. Prices vary by clinic depending on required labs and vaccines—compare options to fit your budget and schedule. (USCIS) 

How long is my I-693 valid? 
Per the June 11, 2025 USCIS update, your I-693 is generally valid only for the specific application it was submitted with and while that application is pending. (USCIS) 

Clear next steps 

• Find USCIS-approved doctors: Use the USCIS Civil Surgeon Locator, 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 don’t open the sealed packet. 

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

Sources (USCIS/CDC) 

• USCIS — Form I-693 (Report of Medical Examination and Vaccination Record) overview. (USCIS) 

• USCIS — Instructions for Form I-693 (sealed envelope & copy to applicant). (USCIS) 

• USCIS — Finding a Medical Doctor (Find a Civil Surgeon) (how to locate designated civil surgeons; compare fees). (USCIS) 

• CDC — Technical Instructions for Civil Surgeons (purpose; scope). (CDC) 

• CDC — TB Technical Instructions (IGRA required for ages 2+; follow-up protocols). (CDC) 

• CDC — Syphilis Technical Instructions (age-based testing). (CDC) 

• CDC — Gonorrhea Technical Instructions (age-based testing; NAAT ordered by civil surgeon at time of exam). (CDC) 

• CDC — Vaccination Technical Instructions + USCIS vaccination page (requirements; one-dose rule when applicable). (CDC) 

• USCIS — Policy Alert (June 11, 2025) on I-693 validity (valid while the related application is pending). (USCIS)