What is the physical exam for immigration? 

TL;DR 

• The immigration physical exam is part of the USCIS Form I-693 medical examination completed by a USCIS-designated civil surgeon inside the U.S. It documents that you meet health and vaccination requirements and that your exam results are sealed for USCIS. (USCIS) 

• The physical exam includes a medical history review, a head-to-toe examination, a mental health assessment, and age-based lab tests (TB, syphilis, gonorrhea), plus vaccination review/updates under CDC Technical Instructions. (CDC) 

• USCIS doesn’t set the price; clinics do. Compare clinics to find the cheapest immigration medical exam that fits your timeline—then keep the packet sealed for USCIS. (USCIS) 

Table of contents 

1. What the immigration physical exam covers 

2. What the civil surgeon looks for 

3. Required tests (how they relate to the physical) 

4. Vaccination review during the exam 

5. Step-by-step: what happens at your appointment 

6. Costs (and why prices differ) 

7. Common mistakes to avoid 

8. FAQs 

9. Sources (USCIS/CDC) 

1) What the immigration physical exam covers 

Inside the United States, the immigration medical examination—often called the green card physical—must be performed by a USCIS-designated civil surgeon using Form I-693 (Report of Medical Examination and Vaccination Record). The civil surgeon completes the form and gives you a sealed envelope for USCIS, plus a copy for your records. (USCIS) 

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

2) What the civil surgeon looks for 

CDC’s Technical Instructions for Civil Surgeons require a physical and mental examination to identify conditions relevant to U.S. immigration law (INA health-related grounds). This includes communicable diseases of public health significance, certain physical or mental disorders with associated harmful behavior, and substance-related disorders. (CDC) 

During the physical exam, the civil surgeon typically: 

• Reviews your medical history (past illnesses, surgeries, medications, substance use, prior TB testing, vaccination records). (CDC) 

• Performs a head-to-toe exam (vital signs; heart and lungs; abdomen; skin; neurologic and musculoskeletal checks; and any focused exams based on history/symptoms). (CDC) 

• Conducts a mental health assessment to screen for disorders that could be linked to current or past harmful behavior, and documents findings in the I-693 (with attachments if relevant). (CDC) 

The civil surgeon records findings on Form I-693 and classifies any conditions per USCIS/CDC guidance; USCIS officers later review the I-693 as part of your application. (USCIS) 

3) Required tests (how they relate to the physical) 

Although this article focuses on the “physical exam,” the immigration medical includes mandatory screenings that often occur on the same visit: 

• Tuberculosis (TB): IGRA blood test required for applicants age 2+, with follow-up (e.g., chest X-ray, evaluation) if indicated by results or symptoms. (CDC) 

• Syphilis: testing required for ages 18 to <45; test others if there’s reason to suspect infection. (CDC) 

• Gonorrhea: testing required for ages 18–24; test others if clinically indicated. NAAT must be ordered by the civil surgeon at the time of the exam—outside results aren’t accepted. (CDC) 

These tests support the medical assessment and are documented on the I-693 along with your physical exam findings. (Outside the U.S., panel physicians perform similar exams under DOS rules.) (CDC) 

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

4) Vaccination review during the exam 

As part of the I-693, the civil surgeon must review your vaccination history and ensure you meet CDC vaccination requirements (age-appropriate immunizations such as MMR, varicella, Tdap, polio, hepatitis B, influenza when in season, etc.). The surgeon notes medically valid reasons if a vaccine is not appropriate (e.g., contraindication, not flu season). You may receive missing vaccines during the visit or via referral. (CDC) 

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

5) Step-by-step: what happens at your appointment 

1. Book a civil surgeon 

 Use the USCIS Find a Civil Surgeon tool to locate USCIS approved doctors, then compare clinics by price and appointment availability. Bring government-issued photo ID and any vaccination records you have. (USCIS) 

2. Intake & history 

 You’ll complete forms covering medical history, medications, prior diagnoses, TB exposure/testing, mental health, and substance use—this frames the exam and any indicated tests. (CDC) 

3. Physical & mental exam 

 The civil surgeon performs a comprehensive head-to-toe physical and a mental health review, documenting relevant positives/negatives for immigration purposes on Form I-693. (CDC) 

4. Required tests & vaccines 

 Based on CDC Technical Instructions, the surgeon orders the TB IGRA, syphilis, and gonorrhea tests (per age/risk) and updates vaccines as needed. (CDC) 

5. Form completion & sealing 

 Once results are in, the civil surgeon completes the I-693, gives you a copy, and provides the official sealed envelope. Do not open it—USCIS only accepts the sealed original. (USCIS) 

CTA: Compare civil surgeons by price & availability → Book now (internal links to your “Find An Immigration Doctor” experience). 

6) Costs (and why prices differ) 

There is no USCIS fee for the immigration physical exam itself; each clinic sets its own price based on exam time, required lab panels, and any vaccines administered. Because prices vary, it pays to compare immigration exam clinics to find an option that fits both your budget and schedule (think “cheapest immigration medical exam” that still meets CDC/USCIS rules). (USCIS) 

7) Common mistakes to avoid 

• Seeing a non-designated doctor. Inside the U.S., the exam must be done by a USCIS-designated civil surgeon. (USCIS) 

• Bringing no records. Lack of vaccine records can lead to extra visits/costs; bring what you have so the surgeon can assess accurately. (CDC) 

• Using outside lab results for gonorrhea: CDC requires the civil surgeon to order NAAT at the time of exam. (CDC) 

• Opening the sealed envelope or forgetting your copy. USCIS requires the sealed original; you should keep a personal copy before sealing. (USCIS) 

FAQs 

Is the immigration physical exam the same as a regular check-up? 

 Not exactly. It’s a standardized immigration exam under CDC Technical Instructions to determine admissibility, including labs and vaccination review tied to immigration law—not a general wellness exam. (CDC) 

Will there be a drug test? 

 There’s no automatic drug screen for everyone. Civil surgeons evaluate for substance-related disorders and order indicated testing based on history/exam. (CDC) 

Who needs a chest X-ray? 

 Only those who need follow-up based on TB screening results or symptoms per CDC TB Technical Instructions. Not every applicant gets an X-ray. (CDC) 

What ages are 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 clinically indicated; NAAT must be ordered by the civil surgeon at the time of the exam. (CDC) 

Do I submit the exam results myself? 

 Yes. Submit the original sealed I-693 envelope with your AOS filing (or in response to an RFE). Keep your personal copy for records. (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 exam doctor. (USCIS) 

• Book now: Bring photo ID and vaccination records; follow your clinic’s 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: Report of Immigration Medical Examination and Vaccination Record (exam overview & filing instructions; sealed packet). (USCIS) 

• CDC — Technical Instructions for Civil Surgeons (purpose; physical & mental examination). (CDC) 

• CDC — Medical History & Physical Examination (what the civil surgeon evaluates). (CDC) 

• CDC — Mental Health Technical Instructions (documentation and attachments). (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 (immigration vaccination table & documentation). (CDC) 

• USCIS — Policy Manual, Vol. 8, Part B, Ch. 4 (officer review of medical documentation). (USCIS)