About medical exams when applying for a green card

Q. I am intending to apply for legal permanent resident status, and I understand that a medical examination is part of the application process. Why is that necessary? Can my primary care provider write a letter that I am in good health?


A. US Citizenship and Immigration Services (USCIS) requires medical examinations in order to determine whether there are any public health-related issues that would affect a prospective immigrant’s admissibility to the United States. The exam can identify medical conditions that require follow-up care. As part of the exam, the physician also will ensure that required vaccinations have been administered. Applicants for permanent residence who came to the US on a K fiancé or K spousal visa will have had a medical examination as part of the visa application process at home, so they will not need to repeat the full procedure when applying for adjustment of status here in the US, but rather they will only need to demonstrate that they meet the vaccination requirements.

All medical examinations include a physical examination, a mental health status evaluation, a skin test for tuberculosis, and a blood test. Generally speaking, the results of the examination are valid for two years from the date of the civil surgeon’s signature.

As discussed above, applicants need to show that they are current with all vaccinations recommended by US public health officials. To find the complete list of such vaccinations, you should visit this webpage, uscis.gov/tools/designated-civil-surgeons/vaccination-requirements. Since the pandemic, immunization against Covid-19 is now a requirement. The physician can administer any vaccinations necessary, or the physician can refer an applicant to another location to receive the missing vaccinations. If a particular vaccination is not “medically appropriate,” then the civil surgeon can certify that fact and make a note on the Form I-693.

You cannot have the medical examination done by your primary care physician or family doctor. You need to choose a doctor from the USCIS list of government-approved physicians known as “Civil Surgeons” in your area, and you must pay the cost of the exam. You can find an approved physician in your area on the USCIS website at uscis.gov/tools/find-a-civil-surgeon. If you enter your zip code or state, the screen will display a list of approved physicians in your area. You can also sort by the civil surgeon’s language and gender. The doctor will charge a fee for the exam, which will vary by medical practice, and will then fill out the Form I-693 and the required vaccination supplement. The results from the examination are placed in a sealed envelope; you must not open the envelope as that invalidates the exam. You should be given a copy of the exam for your records, and if you are not, then contact the civil surgeon and request the copy. 

If you have any questions about the medical exam, especially if you have a physical or mental condition that you believe could affect your eligibility to become a legal permanent resident, visit one of Rian’s legal clinics across the Boston Public Library system or call us to schedule a consultation over the phone.


Disclaimer: These articles are published to inform the general public, not to advise in individual cases. All law, including immigration law, is always subject to change. If you seek legal advice, you can contact Rian’s immigration legal staff at 617-984-6542.


Rian Immigrant Center

One State Street, Suite 800, Boston, MA  02109

Telephone (617) 542-7654

Website: riancenter.org