Immigration Medical Exam Requirements for Green Card Applicants

The I-693 medical exam is required for anyone applying for an immigrant visa or adjusting their status to permanent resident (green card) from within the United States. This includes family-based petitions, employment-based applications, and other adjustment-of-status categories.

If you are filing Form I-485 (Application to Register Permanent Residence), you will need a completed I-693 signed by a USCIS-designated Civil Surgeon. The exam must be performed by a Civil Surgeon. A regular doctor cannot complete this form.

If you are not sure whether you need this exam, your immigration attorney can confirm based on your case type. You can also call us at 301-200-0960 and we will help you figure out whether this applies to you.

If you have already filed your I-485 without the I-693, USCIS may issue a Request for Evidence asking you to submit it. In that situation, you typically have a limited window to respond. Scheduling the exam promptly matters, and our office prioritizes patients working against filing deadlines.

The I-693 exam has several required components. All of them are handled during your appointment at Pandora Family Medicine.

1. 1

   Physical examination

   A standard medical exam covering your general health, vision, hearing, and any conditions that USCIS requires documentation of. This is a medical evaluation, not an interrogation. Dr. Gougian conducts each exam with care and respect for your privacy.

2. 2

   Vaccination review

   USCIS requires proof of certain vaccinations. We review your existing records first and run titer (blood) tests to check for immunity you may already have. You only get the vaccines you actually need. This approach saves you money and avoids unnecessary shots.

3. 3

   TB screening

   A tuberculosis screening is required. This is typically a blood test (QuantiFERON) done the same day as your exam. If you have previous positive TB test results, bring those records so we can determine what additional steps, if any, are needed.

4. 4

   Lab work

   Blood draws for titer testing and any other required labs are performed on-site at our office. You do not need to go to a separate lab facility.

5. 5

   Sealed I-693 envelope

   Once all lab results are back and any needed vaccinations are complete, Dr. Gougian signs the I-693 form and provides it in a sealed envelope. You submit this envelope to USCIS with your application. Turnaround is typically one to two weeks, depending on lab results and vaccination timing.

USCIS requires applicants to show proof of vaccination against specific diseases. The list includes:

• Measles, Mumps, Rubella (MMR)
• Hepatitis A and Hepatitis B
• Varicella (chickenpox)
• Tetanus, Diphtheria, Pertussis (Tdap)
• Polio
• Influenza (seasonal, if applicable)
• COVID-19
• Any other vaccinations recommended by the Advisory Committee on Immunization Practices for the applicant's age group

This list looks long, but many applicants already have immunity to several of these diseases from childhood vaccinations or prior illness. That is why we run titer blood tests before administering anything. If your blood shows you are already immune, you skip that vaccine and the cost along with it.

Bring whatever vaccination records you have. Records from any country are accepted. Even partial records help us determine what you may not need.

Having the right documents ready saves time and can reduce the number of vaccinations you need. Here is what to bring:

• Government-issued photo ID. Your passport is preferred because it matches your immigration records. A state-issued ID or driver's license is also accepted.
• Vaccination records. Bring everything you have, from any country, in any language. Even partial records can prove immunity and reduce the number of new vaccines you need. Childhood immunization cards, school health records, and prior doctor's records all count.
• Prior TB test results. If you have ever been tested for tuberculosis, bring those results. A documented negative test may simplify this part of the exam. A prior positive result does not disqualify you, but we will need to evaluate it.
• Medical records for chronic conditions. If you are being treated for any ongoing health condition, bring relevant records so Dr. Gougian can document them accurately on the I-693.
• I-693 form. You can download it from the USCIS website or we can provide a copy at your appointment.

If you do not have any of these documents, come to your appointment anyway. We can work with whatever records are available and order the tests we need. Missing records simply mean we will rely more on titer blood tests to determine your immunity status.

Only a USCIS-designated Civil Surgeon can perform the I-693 exam. Your regular doctor, a walk-in clinic, or an urgent care center cannot complete this form. If a non-designated physician signs the I-693, USCIS will reject it and you will need to start over.

You can verify that a physician is a designated Civil Surgeon by searching the USCIS Civil Surgeon Locator. Dr. Rachel Gougian at Pandora Family Medicine is listed there and has completed thousands of immigration exams for applicants across the DC, Maryland, and Virginia area.

When choosing a Civil Surgeon, consider whether the physician explains what is happening at each step, whether they test for existing immunity before vaccinating, and whether they offer the exam in your preferred language. At Pandora Family Medicine, the exam is available in English and Spanish.

Some clinics batch immigration exams through high-volume processing. At Pandora Family Medicine, your exam is conducted by Dr. Gougian personally, with time to answer your questions and explain each part of the process. If you have a complex medical history or prior positive TB results, that personal attention makes a meaningful difference in the quality and accuracy of your I-693.

The I-693 form is valid for two years from the date the Civil Surgeon signs it. USCIS must receive it within that window. If the form expires before USCIS adjudicates your case, you will need a new exam.

If your attorney or case timeline suggests you should complete the exam by a certain date, schedule early. It is better to have the form ready to submit than to delay your filing because you are waiting on lab results. Our typical turnaround from exam to sealed envelope is one to two weeks.