If you’re applying for a green card, or adjustment of status, in the United States, one crucial step in the process is completing an immigration medical examination. This exam isn’t just any routine check-up; it must be conducted by a physician specifically designated by U.S. Citizenship and Immigration Services (USCIS). These designated doctors are known as civil surgeons, and ensuring you find the right one is essential for your application.
USCIS authorizes certain doctors, referred to as civil surgeons, to perform these mandatory immigration medical exams for most green card applicants. For U.S. veterans, active military members, and their eligible dependents, military physicians at military treatment facilities within the U.S. are also authorized as blanket designated civil surgeons. It’s also worth noting that for some adjustment of status applicants, only the vaccination component of the medical examination is required. In specific cases, refugee applicants may be able to visit their local health department, where health department blanket designated civil surgeons are available. It’s important to understand that these blanket designated civil surgeons at health departments are generally not listed on the standard USCIS online search tool for civil surgeons, yet they are fully authorized to conduct the entire examination, or specific parts of it. For in-depth information on blanket designated civil surgeons, you can refer to the USCIS Policy Manual, specifically Part C – Civil Surgeon Designation and Revocation.
It’s also critical to distinguish between civil surgeons and panel physicians. Immigration medical examinations required for visa processing outside the United States must be performed by panel physicians, not civil surgeons. Panel physicians are appointed by the Department of State and are based at U.S. Embassies or Consulates abroad. Panel physicians handle immigration medical exams for those applying for visas from outside the U.S., whereas civil surgeons are for individuals applying for adjustment of status from within the United States. Panel physicians cannot perform the medical examination for applicants adjusting status within the U.S. through USCIS.
What You Need to Bring to Your Civil Surgeon Appointment
When you go for your immigration medical examination with a USCIS civil surgeon, being prepared will make the process smoother. Make sure to bring the following items to your appointment:
- Form I-693, Report of Medical Examination and Vaccination Record: It’s essential to bring the official Form I-693. While the civil surgeon will complete much of it, having your copy ready is important.
- Government-issued Photo Identification: You’ll need to prove your identity with a valid government-issued photo ID. This could be a passport or a driver’s license. For children 14 years old and younger, bring identification that verifies their name, date and place of birth, and parents’ full names. Acceptable forms of identification for children include a birth certificate (with a certified English translation if it’s not in English) or an affidavit.
- Vaccination or Immunization Records: Bring any records you have of past vaccinations. This is important because you may need to receive certain vaccinations as part of the immigration medical exam requirements. Common vaccinations include those for DT, DTP, DTaP, Td, Tdap, OPV, IPV, MMR, Hib, hepatitis A, hepatitis B, varicella, pneumococcal influenza, rotavirus, meningococcal disease, and COVID-19.
- Health Insurance Card (Optional): It’s a good idea to bring your health insurance card. While many health insurance plans do not cover the immigration medical examination, it’s worth asking the civil surgeon’s office if they accept your insurance for any part of the exam or related services. It’s best to clarify this beforehand.
- Payment: Be prepared to pay for the examination. Contact the civil surgeon’s office to confirm what forms of payment they accept – such as cash, credit card, or money order. It’s also wise to call several civil surgeons in your area to inquire about their fees for the immigration medical examination, as prices can vary significantly, sometimes by hundreds of dollars. This comparison shopping can help you manage costs.
What to Expect During Your Immigration Medical Exam
The immigration medical examination with a civil surgeon involves a thorough review of your medical history and a physical examination. Here’s a more detailed look at what you can expect:
The civil surgeon will conduct a comprehensive assessment, starting with a detailed review of your medical history. They will ask you about past illnesses, surgeries, hospitalizations, and any ongoing health conditions. Following the medical history review, you will undergo a physical examination. This is a general health check to assess your current physical condition.
In addition to the medical history and physical exam, the civil surgeon is required to perform specific tests for communicable diseases. These tests are mandated by the Centers for Disease Control and Prevention (CDC) and typically include testing for tuberculosis (TB), syphilis, and gonorrhea, with the specific tests depending on your age and other risk factors. The CDC provides detailed guidelines and requirements for the immigration medical examination in their Technical Instructions for Civil Surgeons | CDC. These technical instructions ensure that all civil surgeons follow the same standards and procedures.
After completing the immigration medical examination, the civil surgeon will fill out Form I-693, the Report of Medical Examination and Vaccination Record. Crucially, the civil surgeon will then seal the completed form in an envelope and give it back to you. You are responsible for submitting this sealed envelope to USCIS as part of your green card application package. Before the civil surgeon seals the envelope, ensure you request and receive a copy of the completed Form I-693 for your personal records. It’s extremely important not to open or tamper with the sealed envelope, as USCIS will reject any form received in an opened or altered envelope.
For complete and detailed information about Form I-693 and the immigration medical examination process, you can visit the official USCIS website at uscis.gov/i-693.
Reporting Concerns About a Civil Surgeon
While most experiences with civil surgeons are professional and satisfactory, there may be instances where you have concerns about a civil surgeon’s conduct or actions. If you encounter any issues regarding a civil surgeon’s behavior or actions that you believe are unprofessional or unethical, you have the right to report it. The appropriate step is to contact your state medical board. State medical boards are the regulatory bodies responsible for licensing and overseeing physicians within each state, and they handle complaints related to physician conduct.
If your concerns are specifically about the immigration medical examination process itself or issues related to Form I-693, you should contact the USCIS Contact Center. The USCIS Contact Center is equipped to handle inquiries and complaints directly related to immigration processes and forms, including the medical examination and Form I-693. They can provide guidance and address any issues you may encounter during this part of your green card application.
