The Immigration Medical Exam, Without the Confusion.

If you are applying for a green card from inside the United States, USCIS requires a medical exam reported on Form I-693. It has to be done by a doctor USCIS has designated as a Civil Surgeon. A regular physical from your family doctor does not count, even a thorough one.

The exam checks a short list of things that affect admissibility: certain communicable diseases such as tuberculosis and syphilis, proof of required vaccinations, and a brief review of your physical and mental health history. It is not a test you pass or fail on general health. Most people are healthy, most findings are routine, and the goal is a form that is complete and correct so it does not hold up your case.

That last part matters more than most people realize. A missing signature, an expired lab result, or a vaccine documented the wrong way can send the form back and delay everything. Doing this thousands of times means we know exactly what USCIS is looking for.

1. 1

   Before you come

   Book online or call. Bring a government-issued photo ID, every vaccination record you can find (any language, any country), and any records about past tuberculosis testing or treatment. If your attorney gave you instructions, bring those too.

2. 2

   The visit

   Dr. Gougian reviews your history, does a physical exam, and orders the blood tests USCIS requires for your age group, including tuberculosis (IGRA) and, depending on age, syphilis and gonorrhea testing. Blood is drawn right here, so there is no separate lab trip.

3. 3

   Vaccines, only the ones you need

   We compare your records against the USCIS vaccine list. Where a record exists, you are done. Where one is missing, immunity testing can usually show you are already protected, so you don’t repeat shots you have already had.

4. 4

   Results and the sealed envelope

   When lab results are back, Dr. Gougian completes and signs the I-693 and seals it in an envelope for USCIS. With complete records and normal labs, that is often within a few days of your visit. If a vaccine dose or repeat test is needed, we give you a realistic date before you leave. Don’t open the sealed envelope; you receive a separate copy to keep.

5. 5

   If something turns up

   A positive tuberculosis blood test, for example, usually means a chest X-ray, not a denial. We explain what it means, arrange what is needed, and complete the form when it is done. You are never left guessing.

We know the timeline matters. Many patients are working against an interview date or a request for evidence, and we schedule and process exams with that in mind. The exam is a flat fee quoted before you book; blood tests and vaccines are itemized and added only if you need them, so there are no surprise costs.

Vaccines are where immigration exams get expensive and uncomfortable, and where some clinics take the easy road: no record, no problem, just give the shot. We don’t do that.

Immunity testing is a simple blood test, sometimes called a titer, that measures the antibodies you already have to diseases like measles, mumps, rubella, hepatitis B, and varicella (chickenpox). If you had the vaccine as a child in another country, or had the illness itself, the test usually proves it, and that result satisfies USCIS the same way a vaccine record does.

So the process is simple: bring what you have, test for what is missing, and vaccinate only where you are truly not protected. No guesswork, no treating patients like pincushions, and no paying for shots you don’t need. A few vaccines, such as the seasonal flu shot and Tdap, can’t be shown through a blood test and may still be required depending on the season and your age.

Dr. Gougian sees patients in English and Spanish, and so the exam happens in your language too. Not a phone interpreter, not a translated pamphlet: the doctor asking about your history, explaining your vaccine options, and telling you what happens next. Family members are welcome to come along.

Prince George’s County is home to many Spanish-speaking families, and we built this into the practice on purpose. Many patients who first come for an immigration medical exam later establish care here as primary care patients, and they never have to repeat their story to a stranger.

Our office is at 6300 Baltimore Ave, University Park, MD 20782, on Route 1 between Hyattsville and College Park, a short drive from Washington, DC and close to Metro’s Green Line.

Patients come from across the region because there are not many Civil Surgeons who do this volume of exams, and fewer still who do them in Spanish. We regularly see patients from Hyattsville, College Park, Langley Park, Takoma Park, Silver Spring, Riverdale Park, Greenbelt, Laurel, and Washington, DC.