• Civil Surgeon (In the U.S)
• Panel Doctor (Outside of the U.S)

• Blood pressure, eye test, check your knees, elbows, and may also include an exam of your genital organs.
• A review of your mental status.
• Evaluation of physical and mental disorders with associated harmful behaviors and substance-related disorders
• Other Sexually Transmitted Diseases (Chancroid, Gonorrhea, Granuloma Iguinale, Lymphogranuloma Venereum)
• Other Physical or Mental Abnormality, Disease or Disability

Tuberculin (TB) Test:
Applicants who are over the age of 2 years require a Tuberculin Blood Test. Sometimes even the applicants under the age of 2 may require the test if tuberculosis is suspected or if the applicant has a history of TB.

Serologic (blood) Test for Syphilis:
All applicants 15 years of age and above are required to have a Serologic Test for Syphilis. A Serologic Test may be required for an applicant even under the age of 15 if a possibility of infection is suspected.

Vaccinations:
According to United States Immigration Laws, for adjustment of status, the following vaccinations are required:

• Mumps
• Measles
• Rubella
• Polio
• Tetanus and Diphtheria toxoids
• Pertussis

Some doctors include the cost of standard vaccinations in the cost of the medical exam, most will charge for any vaccinations required in addition to the cost of the medical exam and any laboratory fees.

The applicant is responsible for paying all costs of the medical exam, including the cost of any follow-up tests or treatment that may be required. Payments are made directly to the Civil surgeon and/or related health care facility.

• Applicants applying in the United States have to submit Form I-693 Completed by a designated Civil surgeon. Or,
• Applicants applying outside the United States have to submit Form DS-2053 (Formerly Form OF-157) given by the U.S. Consular.

• Government Issued Photo Id.
  For Example Passport / Driving license.
• passport size photograph (applying outside of the United State).
• Appointment letter for visa interview.
• Medical history Documents, if any

• Communicable disease of public health significance.

  It includes 9 infectious medical conditions defined in the HHS regulations.

  1. Severe acute respiratory syndrome (SARS)
  2. Tuberculosis (TB)
  3. Leprosy
  4. Human immunodeficiency virus (HIV/AIDS)

     An Applicant who tests positive for HIV may be able to file a Waiver application.The applicant must also show that his /her Admission in to U.S.:

     • Posed minimal public health danger
     • Holds minimal possibility of spread of infection
     • Will not incur costs to any government agency without Prior consent from that agency.
  5. Syphilis (infectious State).
  6. Cancroids (STD similar to syphilis and herpes)
  7. Gonorrhea
  8. Granuloma inguinale (STD donovanosis)
  9. Lymphogranuloma (STD chlamydia)
• Lack of required vaccinations (for immigrant visa applicants only);
• Physical or mental disorders with harmful behavior.
• Drug abuse or drug addiction.

If applicant’s physical or mental behavior has no associated harmful behavior then applicant is still eligible for the application process.

• Applicant is Spouse or unmarried son or daughter or the minor, unmarried adopted child of a U.S. Citizen or Legal Permanent Resident (LPR); or
• Applicant has a son or daughter or lawfully adopted child who is a U.S. citizen or LPR; or
• Applicants are eligible for classification as a self-petitioning spouse or child (including your derivative children) because of abuse.

Do not accept it if it is not in a sealed envelope. USCIS will return the form to you if it is not in an envelope or if the envelope has been opened or altered. You, the applicant, not the Civil surgeon, are required to submit the Form I-693 to USCIS.

You need to turn in your envelope with your immigration application. Follow the instructions on or included with the application or the instructions given to you by the office requesting the medical examination.

The medical grounds of inadmissibility under U.S. immigration laws are divided into four categories:

1. Communicable diseases of public health significance;
2. Lack of required vaccinations;
3. Physical or mental disorders with harmful behavior; and
4. Drug abuse or addiction.

The Civil surgeon is required to perform a general physical examination and specific evaluations, as described below.

The Civil surgeon is required to perform specific tests for TB, syphilis. The medical exam also indicates an evaluation for other sexually transmitted diseases and Hansen's Disease (leprosy).

If you are found to have a communicable disease of public health significance, the Civil surgeon will advise you how to obtain any necessary treatment. It also may be necessary for you to apply for a waiver of inadmissibility. USCIS will advise you if this is necessary. To obtain more information about this waiver, visit the USCIS Web site.

All applicants for adjustment of status must present documents showing they have been vaccinated against a broad range of vaccine-preventable diseases. The Civil Surgeon will review your vaccination history with you to determine whether you have all the required vaccinations. Make sure you take your vaccination records with you to your appointment with the Civil surgeon.

Do not attempt to meet the requirements before you are evaluated by the Civil surgeon, in case it is not medically appropriate for you to have one or more of the required vaccines.

By law, the required vaccines for the immigration population are the vaccines as recommended by the ACIP for the immigrant population. You may obtain a list of the required vaccines from CDC's Web site at CDC Website

If you never received or are unable to prove you received certain vaccines, the Civil surgeon can administer them to you. After evaluation by the Civil surgeon, you also have the option of asking your family doctor to administer those vaccines to you and showing the records to the Civil surgeon to note on Form I-693.

If you initially did not have documents proving you received all the required vaccines but later submit those documents, or if the Civil surgeon certifies that it is not medically appropriate for you to have one or more of the missing vaccine(s), USCIS may grant you a waiver based on the Civil surgeon's certification on the vaccination supplement.

HHS has determined that a vaccine is "not medically appropriate" if :

• The vaccine is not recommended for your specific age group;
• There is a medical reason why it would not be safe to have the vaccine (for example, allergies to eggs and yeast, hypersensitive to prior vaccines, other medical reasons);
• You are unable to complete the entire series of a required vaccine within a reasonable amount of time; or
• For the influenza vaccine, it is not the flu season.

If you object to receiving the recommended vaccinations because of your sincerely held religious beliefs or moral convictions, you may apply for a waiver of these requirements. If you hold these objections, inform the Civil surgeon that you will apply for a waiver. If the waiver application is denied, you may be ineligible for the immigration benefit that you are seeking. To obtain more information about these waivers, visit the USCIS Web site .

No. The emphasis is more on the behavior associated with the physical or mental disorder, instead of the physical or mental disorder itself. This means that the Civil surgeon must determine that there is behavior associated with the disorder that is harmful either to you, to others, or to property. If you have had a history of a physical or a mental disorder, there must be associated harmful behavior that is likely to recur in order for you to be considered inadmissible.

The Civil surgeon will ask you general questions during the medical exam to determine whether you have such a condition. Depending on the outcome of the initial exam, the Civil surgeon may find it necessary to refer you to a specialist for further testing.

If the Civil surgeon finds that you have a physical or mental disorder with associated harmful behavior, you may apply for a waiver according to the terms, conditions, and controls determined necessary by USCIS in consultation with HHS. To obtain more information about these waivers, visit the USCIS Web site.

The Civil surgeon will review your medical history during the medical exam and ask you questions necessary to determine whether you are currently using or have used in the past any drugs or other psychoactive substances. The medical guidelines for determining drug abuse and drug addiction are determined by HHS.

If the Civil surgeon determines you have a medical condition of drug addiction/abuse, you are noteligible to apply for a waiver unlessyou are applying for adjustment of status one year after you were admitted as a refugee, or you are applying for adjustment of status one year after you were granted asylum. If you are ineligible to apply for a waiver, but are later found by the Civil surgeon to be in remission from the drug abuse or drug addiction (as determined by HHS), you may proceed with your adjustment-of-status application, if eligible.

• Hepatitis B
• Influenza (No, if less than 6 months old)

• DTP/DTaP/DT
• Polio** (IPV/OPV)
• Rotavirus*** (6 weeks to 8 months )
• Hib (2 through 59 months old )
• Hepatitis B (through 18 years old)
• Pneumococcal - 2 through 59 months old (administer PCV)
• Influenza (No, if less than 6 months old)

• DTP/DTaP/DT
• Polio** (IPV/OPV)
• Measles, Mumps, and Rubella (if born in 1957 or later )
• Hib (2 through 59 months old)
• Hepatitis A (12 through 23 months old)
• Hepatitis B (through 18 years old)
• Varicella
• Pneumococcal - 2 through 59 months old (Doctor may administer PCV)
• Influenza - Yes, ≥ 6 months (annually when flu vaccine is available in country of exam)

• Td/Tdap (Sometimes*)
• Polio** (IPV/OPV)
• Measles, Mumps, and Rubella (if born in 1957 or later)
• Hepatitis B (through 18 years old)
• Varicella
,li>Influenza - Yes, ≥ 6 months (annually when flu vaccine is available in country of exam)

• Td/Tdap (Doctor may substitute 1-time dose of Tdap for Td booster; then boost with Td Every 10 Years)
• Polio** (IPV/OPV)
• Measles, Mumps, and Rubella (if born in 1957 or later )
• Hepatitis B (through 18 years old )
• Meningococcal (MenACWY) - (11 through 18 years old)
• Varicella
• Influenza - Yes, ≥ 6 months (annually when flu vaccine is available in country of exam)

• Td/Tdap (Doctor may substitute 1-time dose of Tdap for Td booster; then boost with Td Every 10 Years)
• Measles, Mumps, and Rubella ( if born in 1957 or later)
• Varicella
• Influenza - Yes, ≥ 6 months (annually when flu vaccine is available in country of exam)

• Td/Tdap (Doctor may substitute 1-time dose of Tdap for Td booster; then boost with Td Every 10 Years)
• Varicella
• Pneumococcal (Doctor may administer either PCV or PPSV depending on vaccination history)
• Influenza - Yes, ≥ 6 months (annually when flu vaccine is available in country of exam)

• DTP=pediatric formulation diphtheria and tetanus toxoids and pertussis vaccine;
• DTaP=pediatric formulation diphtheria and tetanus toxoids and acellular pertussis vaccine;
• DT=pediatric formulation diphtheria and tetanus toxoids;
• Td=adult formulation tetanus and diphtheria toxoids;
• Tdap=adolescent and adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccine
• * (Children 7-10 years old sometimes need a dose of Tdap depending on their vaccine history. See Diphtheria, Tetanus and Pertussis-Containing Vaccines Catch-Up Guidance on CDC’s website for additional information.); IPV=inactivated poliovirus vaccine (killed); OPV=oral poliovirus vaccine (live); Hib=Haemophilus influenzae type b conjugate vaccine; MenACWY=quadravalent meningococcal conjugate vaccine; PCV=pneumococcal conjugate vaccine; PPSV=pneumococcal polysaccharide vaccine.
• ** Please see posted Addendum to Technical Instructions for Panel Physicians for Vaccinations on CDC’s website for changing guidance about polio vaccine.
• *** Rotavirus vaccination should not be initiated for infants aged 15 weeks 0 days or older.
• This table describes vaccine requirements for U.S. immigrant visa and status adjustment applicants only and does not include recommendations for other clinical purposes. See the Immunization Schedules on CDC’s website for number and spacing of doses for required vaccines.

Disclaimer: The chart and the information shall not to be taken as legal or clinical advise. It is given as represented by CDC's website. It may subject to change without prior notice.

• Check your overall health.
• Test for tuberculosis (TB), syphilis, and gonorrhea (depending on your age).
• Review your vaccination history.
• Ask questions about your physical and mental health and any drug use.

You may need to get certain vaccines or follow-up tests based on the results.

• Complete Part 1 with your personal information.
• Write your name and A-number at the top of each page.
• Do not sign Part 2 until you're in front of the doctor.
• The doctor will complete the rest of the form.

• With your green card application (Form I-485), or
• As instructed by USCIS.

• Your vaccination records (Part 10), and
• Certain sections of the form.

Check with your civil surgeon to confirm.

• Certain serious diseases (like active TB).
• Missing required vaccinations.
• Physical or mental disorders that involve harmful behavior.
• A history of drug abuse or addiction.

• Denial of your application.
• Legal consequences.
• Being barred from entering the U.S.

Always be honest and accurate.