USCIS Physicals: Your Complete Guide to the Immigration Medical Exam (Form I-693)

Adjusting your status to become a permanent resident (getting a Green Card) is a major milestone in your immigration journey. An essential part of this process involves a medical examination, which is officially reported on Form I-693 (Report of Medical Examination and Vaccination Record).

Why Is the USCIS Physical Required?

The primary purpose of the immigration medical exam is to protect public health. The United States Citizenship and Immigration Services (USCIS) requires this exam to ensure that an applicant does not have any health conditions that would make them "inadmissible" to the United States on public health grounds.

During the exam, the Civil Surgeon screens for four main categories of medical inadmissibility:

• Communicable diseases of public health significance (such as active Tuberculosis, Syphilis, and Gonorrhea).
• Failure to show proof of required vaccinations.
• Physical or mental disorders with associated harmful behavior.
• Drug abuse or addiction.

Who Needs It?

Generally, anyone applying for adjustment of status to that of a lawful permanent resident (Green Card) from within the United States must submit a completed Form I-693. This includes:

• Family-based applicants (spouses, parents, children of US citizens/permanent residents).
• Employment-based applicants.
• Refugees and certain asylees adjusting status.
• Certain nonimmigrant visa holders changing their status.

Step-by-Step Process

1. Find a Designated Civil Surgeon

You cannot go to your regular primary care doctor for this exam unless they are specifically authorized by USCIS. You must see a "Civil Surgeon"—a doctor designated by USCIS to perform these specific medical exams. Dr. Perry Weisman at WiseCare is an experienced, authorized Civil Surgeon.

2. Prepare Your Documents

To ensure a smooth visit, bring the following to your appointment:

• A valid government-issued photo ID (Passport or Driver's License).
• Your complete vaccination records (translated into English if necessary).
• A printed copy of the most recent Form I-693. Note: At WiseCare, we pre-fill portions of this for you when you book.
• Any relevant medical records regarding past treatment for TB, syphilis, or psychiatric conditions.

3. What Happens During the Exam

The Civil Surgeon will review your medical history and conduct a physical examination. This is not a comprehensive primary care physical, but a targeted screening.

Required Lab Tests:

• Blood test for Syphilis (for applicants aged 15 and older).
• Urine test for Gonorrhea (for applicants aged 15 and older).
• Interferon Gamma Release Assay (IGRA) blood test for Tuberculosis (for applicants aged 2 and older).

Required Vaccinations:

The Civil Surgeon will review your immunization record to ensure you have received all vaccines required by the Advisory Committee on Immunization Practices (ACIP). Requirements vary by age but typically include:

• Measles, Mumps, Rubella (MMR)
• Polio, Tetanus and Diphtheria Toxoids
• Pertussis, Haemophilus influenzae type B
• Hepatitis A and B
• Varicella, Influenza, Pneumococcal pneumonia
• COVID-19: Applicants must be fully vaccinated against COVID-19 using an approved vaccine formulation.

4. After the Exam

Once all test results are back and vaccination requirements are met, the Civil Surgeon will complete Form I-693, sign it, and seal it in an envelope. Do not open this envelope under any circumstances. You must submit the envelope to USCIS exactly as it was given to you. The doctor will provide you with a separate copy for your personal records.

Validity of Form I-693

Historically, a completed Form I-693 was valid for two years from the date the Civil Surgeon signed it. However, USCIS frequently updates these guidelines. Currently, forms signed by a Civil Surgeon on or after Nov. 1, 2023, do not expire and retain their evidentiary value indefinitely, though officers have discretion to request a new one if they have reason to believe the applicant's health has changed.

Tips for Success

• Do not guess on vaccines: Don't rush to get random vaccines before your visit. Bring what records you have, and the Civil Surgeon will tell you exactly what is missing based on current CDC guidelines.
• Be honest: Disclose all past medical conditions. Having a history of a disease like TB does not automatically disqualify you, provided it was properly treated.
• Schedule early: Lab results (especially for TB) can take several days to process. Do not schedule your exam the day before your USCIS interview.

Common Questions

• Does health insurance cover the cost? Generally, no. Most health insurance plans do not cover immigration or administrative physicals. This is typically an out-of-pocket expense.
• What if I test positive for TB? A positive IGRA blood test means you have been exposed to TB. You will likely require a chest X-ray to rule out active disease.

Final Thoughts

The immigration medical exam is a critical hurdle, but with proper preparation and an experienced Civil Surgeon, it can be completed efficiently. For the most up-to-date form and official instructions, always visit the official USCIS website.

Disclaimer: The information provided in this article is for educational purposes only and does not constitute legal or medical advice. Immigration laws and medical requirements are subject to change. Always consult with a qualified immigration attorney and a designated Civil Surgeon regarding your specific case.