Immunity Testing for Your Immigration Medical Exam

A titer test is a blood test that measures whether you already have immunity to a specific disease. For the I-693 immigration medical exam, USCIS requires proof of vaccination against a set list of diseases. But having the vaccine in the past and having documented proof of it are two different things, and so is actually being immune.

Titer testing is how we find out what you already have before deciding what, if anything, you still need. If your blood shows you are immune to measles, for example, there is no reason to vaccinate you for measles again. The test confirms what your body already knows.

This matters because vaccines are where immigration exams get expensive and uncomfortable. Some clinics give every patient the same set of shots regardless of history. We do not do that. Patients only get vaccines they actually need, no guesswork, no treating every patient like a pincushion. Titer testing is how we back that up.

1. 1

   What your records can do for you

   Bring every vaccination record you have, even if it is handwritten, in another language, or from another country. We review what you have against the USCIS requirements. Where your records document a completed series, we accept them. Where records are missing or incomplete, titer testing can often confirm immunity without repeating the vaccine.

2. 2

   When titer testing applies

   Titer tests are most commonly used for measles, mumps, rubella, varicella, and hepatitis B, diseases where a blood test can reliably confirm immunity. For some other vaccines on the USCIS list, titers are not the standard method, and we will walk you through what applies to your specific situation at your appointment.

3. 3

   A note on cost

   Titer tests and any vaccines you do need are separate from the flat exam fee. We quote everything before you book so there are no surprise costs. The number of tests and vaccines depends on your records and your results, which is exactly why we test first.

4. 4

   Results and the sealed envelope

   Once your titer results are back and any needed vaccines are given, Dr. Gougian completes and signs the I-693 and seals it in the envelope you submit to USCIS. You do not open it. Most patients have their sealed envelope within one to two weeks of their appointment, and often sooner.

5. 5

   If something comes back unexpected

   A positive tuberculosis blood test, for example, usually means a chest X-ray is needed before the I-693 can be completed. It does not automatically mean your case is in trouble. Dr. Gougian will explain what the result means and what the next step is, plainly and without alarm.

We know the timeline matters. Many patients are working against an interview date or a filing deadline. We factor that in from the first call.

When you come in for your immigration medical exam, Dr. Gougian reviews your vaccination records first. If your records are complete and documented, you may not need any titer tests at all. If there are gaps, we draw blood in the office that same day to check for immunity to the relevant diseases.

Results typically come back within a few days. Once we have them, we know exactly what you are immune to and what, if anything, still needs to be addressed. If a vaccine is needed, we give it. If you are already immune, you are done. No automatic re-vaccination, no assumptions.

The goal is simple: confirm what you already have, fill in only what is actually missing, and get your I-693 completed correctly.

Dr. Gougian conducts exams in English and Spanish. The whole appointment, the history review, the physical, the explanation of results, happens in the language you are most comfortable in.

Prince George's County is home to many Spanish-speaking families navigating the immigration process, and we built this practice to serve this community directly. You should not have to bring a translator to a medical appointment.

Our office is at 6300 Baltimore Ave, University Park, MD 20782, on Route 1 between College Park and Hyattsville. There is parking on site, and the office is accessible by public transit.

Patients come from across the region. Civil Surgeons who also offer on-site titer testing and same-week appointments are not easy to find, and we see patients from throughout the DC metro area.