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A Detailed Guide: What to Expect at Your Green Card Medical Exam

In order to apply for a U.S. green card (lawful permanent resident status), you must undergo a medical examination. The purpose behind the examination is to ensure that you are not inadmissible to the United States on public health grounds.

However, you cannot simply undergo a medical examination with your regular doctor. Instead, a civil surgeon who has been specifically designated by the U.S. government must perform the required medical examination. The civil surgeons who are qualified to perform green card medical examinations receive special, ongoing training in these areas.

Finding an authorized civil surgeon
If you are applying for your green card from overseas through a U.S. consulate or embassy (known as Immigrant Visa Processing), the consulate will provide you with a list of authorized civil surgeons before you attend your visa interview. You can also access the list here. Choose your country from the drop down menu and you will be provided with a list of doctors.

If you are applying for your green card from within the United States (known as Adjustment of Status), you can find the list of qualified civil surgeons in your area here. Simply enter your zip code and the website will generate the list of doctors closest to you.

What to bring to the medical examination
In preparation for the medical exam, you should be sure to bring the following:
Valid passport or other government issued photo identification;
• Your vaccination records;
• If you are adjusting status, a copy of Form I-693, Report of Medical Examination and Vaccination Record;
• The required fee (varies by doctor);
• If applying abroad, the required number of U.S. passport photos (varies by country);
• For anyone in your family immigrating with learning disabilities, a report of their condition and any special education or supervision requirements;
• If you are being treated for a chronic medical condition or taking medications on a regular basis, a list of the medications (also be prepared to explain your conditions);
• If you’ve had a previous positive skin test for tuberculosis (TB), a certificate from your doctor giving the circumstances of the positive test result, indicating any treatment prescribed and how long it lasted. If you have ever been diagnosed with tuberculosis, you must present a written certification, signed by your doctor, proving that you were adequately treated. The certificate must include dates and types of medications you took;
• If you have had syphilis, a written certificate, signed by a doctor or public health official, proving that you were adequately treated; 
• If you have a history of harmful or violent behavior resulting in injury to people or animals, information that will allow the doctor to determine whether the behavior was related to a psychiatric or medical problem, or to drug or alcohol use; and
• If you have been treated or hospitalized for psychiatric or mental illness, or alcohol or drug abuse, written certification including the diagnosis, length of treatment, and your prognosis.

What the doctor will examine & administer

Standard Physical
The doctor will conduct a standard physical, as you have likely received from your regular doctor before. The doctor will look at your eyes, ears, nose and throat, extremities, abdomen, lymph nodes, skin, and external genitalia. They will also listen to your heart and your breathing.

The civil surgeon will look over your vaccination records to let you know if you will need any vaccinations in order to complete your immigration medical exam. If you have received all required vaccinations and have all necessary records, you will not need to receive any additional vaccinations. If vaccines are required to complete your medical exam, they can be provided on that day or rescheduled for a date in the near future if required.

If you have received vaccinations in the past but do not have your vaccination records, you have the option of having blood titers drawn to prove your immunity. Blood titers are blood tests that can check for certain antibodies against certain diseases. If you have had a full series of vaccinations in the past, the blood titers will prove that you are immune to the disease and do not require the vaccinations. However, if a blood titer comes back as not immune, the vaccination is then required.

The vaccinations required include:
Hepatitis A and B
• Influenza
• Influenza type b (Hib)
• Measles
• Meningococcal
• Mumps
• Pneumococcal
• Pertussis
• Polio
• Rotavirus
• Rubella
• Tetanus and diphtheria toxoids
• Varicella

Tuberculosis (TB) Screening
All applicants two years of age or older are required to have a tuberculin skin test (TST). Children younger than age two are required to have a TST if there is evidence of contact with a person known to have TB or if there is other reason to suspect TB. If evidence of TB infection is found, a chest X-ray is required. Any person with a positive skin test reaction of more than 5mm will also be required to undergo a chest X-ray.

After the TST is administered, the doctor will ask you to return in 48 to 72 hours for the results to be read. If the results are measured as 5mm or larger, you will then be required to have the chest X-ray to rule out tuberculosis as the cause.

Pregnant women must still undergo the X-ray if the TST is found to be 5mm or larger.

Syphilis Blood Test
All applicants age 15 and older are required to be tested for syphilis by USCIS, as well as applicants 14 and under who have symptoms of syphilis or a history of syphilis. The syphilis screening is a blood draw to determine if the applicant has syphilis. The blood draw must be done at the same time as the medical exam and at the civil surgeon’s designated laboratory. If syphilis is detected, the applicant will need to be treated before the I-693 form can be completed.

Gonorrhea Urine Test
All applicants age 15 and older are required to be tested for gonorrhea by USCIS, as well as applicants 14 and under who have symptoms of gonorrhea or a history of gonorrhea. The gonorrhea screening is a simple urine collection. If gonorrhea is detected in the sample, the applicant will need to be treated before the I-693 forms can be completed.

*Applicants should be sure to confirm that the civil surgeon properly completes the form to indicate that the test for gonorrhea was administered.*

Illnesses or conditions that may make you inadmissible
Only certain medical conditions can make you inadmissible to the United States under the Immigration and Nationality Act (I.N.A.), under Sections 212(a) and 221(d). These include:
A communicable disease of public health significance. These include active tuberculosis, gonorrhea, infectious leprosy, and infectious syphilis. HIV was removed from this list on Jan. 4, 2010.
• A physical or mental disorder and a history of behavior associated with the disorder that may pose or has posed a threat to the property, safety, or welfare of the applicant or others.
• A physical or mental disorder and a history of behavior associated with the disorder that may pose or has posed a threat to the property, safety, or welfare of the alien or others, and which behavior is likely to recur or lead to other harmful behavior.
• Abuse of or addiction to drugs.

Submitting the results of your medical exam
If you are applying for your green card abroad through visa processing, the civil surgeon will either give you the medical examination to hand-carry to the visa interview or they will send the results directly to the U.S. consulate or embassy. If it is given to you by hand,
do not open the envelope. The embassy will not accept the medical exam if it has been opened.

If you are applying for your green card through adjustment of status, the doctor will complete Form I-693 and give it to you in a sealed envelope. Do not open the envelope. You must then submit the sealed examination with your application to USCIS. The envelope will not be accepted if it is not sealed.

The results of your examination remain valid for up to one year before you file your application for a green card.

If you are interested in applying for a green card or would like to explore your options for immigrating to the United States, please contact our office to schedule a consultation with one of our attorneys today!