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Green Card Medical Exam FAQ's

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Generally, all the applicants filing for adjustment of status to that of a lawful permanent resident must submit Form I-693 completed by a designated Civil surgeon. Form I-693 is used to report results of a medical examination to the U.S. Citizenship and Immigration Services (USCIS).

The purpose of the Immigration Medical Exam is to ensure that the applicant is not inadmissible to United States on public health grounds. The Immigration Medical Exam process includes Vaccination, Tuberculin (TB) tests and Physical examinations. The physical examinations may consist of blood tests, urine tests, x-rays for Tuberculin tests as per prior medical records and the applicants' mental state and drug abuse levels are examined. A list of these health grounds can be found in section 212(a) (1) of the Immigration and Nationality Act

1. What is an immigration medical exam and why do I need to complete one?

Generally, all applicants filing for immigrant visas and some non-immigrant visas, refugees, and adjustments of status to that of a permanent resident must submit Form I-693 completed by a designated Civil Surgeon.

The examination is required to establish that you are not inadmissible to the United States on public health grounds.

The medical exam typically includes a standard physical exam, blood and urine tests, x-rays, and a review of the applicant’s medical history and mental state.

A Civil Surgeon is a licensed and experienced doctor (Physician) approved/authorized by the USCIS to conduct immigration medical exams.

No, only licensed and experienced doctors approved by the USCIS, who are familiar with immigration medical policy and updates, can perform this exam. These doctors are usually called:
  • Civil Surgeon (In the U.S)
  • Panel Doctor (Outside of the U.S)

Applicants can find designated Civil Surgeons on www.easyime.com, where they can schedule online appointments with the nearest Civil Surgeon. The website also offers tools such as price comparison, office hours, and other related services.

Alternatively, applicants can visit the USCIS website to locate a Civil Surgeon.

Physical examination: Required for all applicants, regardless of age, including:

  • Blood pressure, eye test, check of knees, elbows, and possibly genital organs.
  • Review of mental status.
  • Evaluation of physical and mental disorders with associated harmful behaviors and substance-related disorders.
  • Screening for sexually transmitted diseases (STDs) and other physical or mental abnormalities.

Tuberculin (TB) Test:
Required for applicants over the age of 2 years, and sometimes for those under 2 if TB is suspected.

Serologic (blood) Test for Syphilis:
Required for applicants 15 years and older, and sometimes for those under 15 if infection is suspected.

Vaccinations:
Required vaccinations include Mumps, Measles, Rubella, Polio, Tetanus and Diphtheria toxoids, Pertussis, etc.

Applicants who believe that compliance with the vaccination requirements would be against their religious beliefs or moral convictions are still eligible for Adjustment of Status. They will need to apply for a waiver of vaccination requirements.

Only a panel physician approved by the visa-issuing U.S. Embassy/Consulate can conduct the exam. The closest Consulate or Embassy of the United States Consular office can assist in getting the names of recognized Panel Physicians.

Some doctors include the cost of standard vaccinations in the medical exam fee, but most will charge for any additional vaccinations required. The applicant is responsible for paying all costs of the medical exam, including any follow-up tests or treatment. Payments are made directly to the Civil Surgeon and/or related health care facility.

Applicants applying in the United States must submit Form I-693 completed by a designated Civil Surgeon.

Applicants applying outside the United States must submit Form DS-2053 (formerly Form OF-157) given by the U.S. Consular. The Civil Surgeon will provide the respective form.

  • Government-issued photo ID (e.g., Passport, Driving license).
  • Passport size photograph (if applying outside the United States).
  • Appointment letter for visa interview.
  • Medical history Documents, if any

  • If a chest x-ray is not recommended, the applicant must wait until it is safe to take one.
  • The doctor will administer only the allowed vaccines and advise taking other vaccines after delivery.
  • The doctor may also request gynecologist test results.

  • Communicable diseases of public health significance (e.g., SARS, TB, Leprosy, HIV/AIDS).
  • Lack of required vaccinations.
  • Physical or mental disorders with harmful behavior.
  • Drug abuse or drug addiction.

The Civil Surgeon or panel physician determines if the applicant is inadmissible on medical grounds based on their physical or mental condition.

If there is no harmful behavior associated with the condition, the applicant is still eligible for the application process.

A medical waiver allows an immigration applicant to be admitted or remain in the United States despite having a health condition identified as medical grounds of inadmissibility.

Applicants can apply for a waiver if they are a spouse or unmarried child of a U.S. Citizen or Legal Permanent Resident, or a self-petitioning spouse or child due to abuse.

The Civil Surgeon certifies the results on the appropriate forms and places them in a sealed envelope labeled “DO NOT OPEN THE SEALED ENVELOPE.” Do not open this envelope.

The applicant must submit this sealed envelope with their immigration application. The envelope must remain sealed; otherwise, USCIS will return it to you.

Follow the instructions provided with your immigration application or given by the office requesting the medical examination.

  • The results of the medical examination are generally valid for 24 months.
  • Applicants should schedule the exam close to the time they file for adjustment of status.

  • The results of the medical examination are confidential and used only for immigration purposes.
  • The Civil Surgeon may share results with public health authorities when required by law.

The immigration medical exam typically requires one to three visits to the Civil Surgeon.

  • First Visit: During the initial visit, the Civil Surgeon will conduct a physical examination, review your medical history, and perform necessary tests such as blood and urine tests, and possibly x-rays.
  • Follow-Up Visits: If additional tests or vaccinations are required, you may need to return for follow-up visits. For example, if a Tuberculin Skin Test (TST) is performed, you will need to return within 48 to 72 hours to have the results read.
  • Completion: The total time to complete the exam can vary based on the availability of test results and any additional medical evaluations needed.


Tuberculosis (TB)
All applicants two years of age and older are required to be tested for tuberculosis (TB) with an initial screening test. Civil Surgeons may require an applicant younger than two years of age to undergo testing if there is evidence of contact with a person known to have TB or other reasons to suspect TB.
The physician may use either the Tuberculin Skin Test (TST) or an Interferon Gamma Release Assay (IGRA).

  1. Tuberculin Skin Test (TST) given by the Mantoux technique. After the skin test, you will need to return to the Civil surgeon within 48 to 72 hours to have the result read. If you have a reaction of four millimeters or less, generally, you will not need any further tests for TB. A chest x-ray is required when the reaction to the TST is five millimeters or more. The Civil surgeon will explain the medical requirements to you in more detail.
  2. IGRA: IGRAs are blood tests that are options to the TST (see update to the Technical Instructions at CDC Website) You will not have to return to the Civil surgeon's office for the result to be read. The result is generally available within 24 hours. If the test is negative or indeterminate/borderline/equivocal, you generally will not need any further tests for TB. Depending on the result of the test, further evaluation with a chest x ray may be required.
       Tests not listed in the materials published on this link may not be used for purposes of this immigration medical examination.
       The Civil surgeon will explain the medical requirements and the suitability and availability of IGRA testing to you in more detail.
Syphilis All applicants 15 years of age and older must have a blood test for syphilis. Civil Surgeons may require applicants under 15 years of age to be tested if there is reason to suspect the possibility of infection.

If you forget your username and password for the easyIME website, you can recover them by following these steps:
  • Email Request: Send an email request to support@easyime.com from the email account you used to register with the website.
  • Information Required: Include your name and phone number in the email to verify your identity.
  • Response: The support team will re-send your username and password to the email address associated with your account.

After completing your immigration medical exam, there are several steps you need to follow to proceed with your immigration application:
  • Sealed Envelope: The Civil Surgeon will place the certified results of your medical exam in a sealed envelope labeled “DO NOT OPEN THE SEALED ENVELOPE.” Do not open this envelope.
  • Submission: You, the applicant, are responsible for submitting this sealed envelope to the USCIS along with your immigration application. The envelope must remain sealed; otherwise, USCIS will return it to you.
  • Instructions: Follow the instructions provided with your immigration application or given by the office requesting the medical examination. This may include specific guidelines on how to submit the medical exam results.

Required vaccinations vary by age group. For example:
  • Birth to 1 Month: Hepatitis B, Influenza (if older than 6 months).
  • 2 to 11 Months: DTP/DTaP/DT, Polio, Rotavirus, Hib, Hepatitis B, Pneumococcal, Influenza.
  • 12 Months to 6 Years: DTP/DTaP/DT, Polio, MMR, Hib, Hepatitis A, Hepatitis B, Varicella, Pneumococcal, Influenza.
  • 7 to 10 Years: Td/Tdap, Polio, MMR, Hepatitis B, Varicella, Influenza.
  • 11 to 17 Years: Td/Tdap, Polio, MMR, Hepatitis B, Meningococcal, Varicella, Influenza.
  • 18 to 64 Years: Td/Tdap, MMR, Varicella, Influenza.
  • 64+ Years: Td/Tdap, Varicella, Pneumococcal, Influenza
  • 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.

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