The Immigration Medical Exam, Without the Confusion

If you are applying for a green card from inside the United States, USCIS requires a completed Form I-693 signed by a Civil Surgeon. Not just any doctor. It has to be a physician USCIS has specifically designated for this purpose. Dr. Gougian holds that designation.

The exam checks a short list of things that affect admissibility: certain communicable diseases, vaccination history, and a general physical. The Civil Surgeon reviews your records, orders any required lab work, and documents everything on the I-693 in a format USCIS will accept.

That last part matters more than most people realize. A missing signature, an expired form, or a vaccine recorded incorrectly can delay your case. Thousands of completed exams means Dr. Gougian has seen the paperwork edge cases and knows how to avoid them.

1. 1

   Before you come

   Book online or call 301-200-0960. Bring a government-issued photo ID and every vaccination record you have, even old ones, even records in another language. The more documentation you arrive with, the fewer vaccines you may need.

2. 2

   The visit

   Dr. Gougian reviews your medical history, completes a physical exam, and orders the required blood tests. Blood is drawn here in the office. No separate lab visit, no extra trip.

3. 3

   Vaccines, only the ones you need

   Your records are compared against the USCIS vaccine requirements. Where documentation exists, you are covered. Where immunity is unclear, we can run a titer test before assuming you need a repeat vaccination. You only pay for what you actually need.

4. 4

   Results and the sealed envelope

   Once lab results are back, Dr. Gougian completes and signs the I-693 and seals it in the envelope you will bring to USCIS or your immigration attorney. Do not open it. The seal is what makes it valid.

5. 5

   If something turns up

   A positive tuberculosis blood test, for example, usually means a chest X-ray, not automatic disqualification. Dr. Gougian will walk you through what any follow-up means and what USCIS actually requires next.

We know the timeline matters. Many patients are working against an interview date or a filing deadline. We are straightforward with you about how long each step takes so you can plan accordingly.

Vaccines are where immigration exam costs can climb fast, and where a lot of practices take a one-size-fits-all approach that ends up costing patients more than necessary. We do it differently.

A titer test is a simple blood draw that measures whether you already have immunity to a specific disease. If you do, you are documented as protected and you skip that vaccine entirely. If you don't, or if the result is borderline, then you get the vaccine. That's it.

Bring whatever records you have. We test for what is unclear and vaccinate only for what is genuinely missing. Patients who have prior immunity do not pay for repeat vaccinations. That is not a policy we debate. It is just the right way to do it.

Dr. Gougian conducts exams in both English and Spanish. The entire visit, your history, the exam, the explanation of results, happens in the language you are most comfortable in. You should not have to work to understand what is happening at your own medical appointment.

Prince George's County is home to many Spanish-speaking families, and this practice was built with that community in mind. If Spanish is your first language, you are in the right place.

The office is at 6300 Baltimore Ave, University Park, MD 20782, on Route 1 between College Park and Hyattsville. Parking is available on site.

Patients come from across the region. Civil Surgeons who complete high volumes of I-693 exams and offer same-week appointments are not as common as you might expect.