Immigration medical exam

Two types of immigration medical exams

The immigration medical exam is required for most green card applicants. There are two types:

• Adjustment of status (inside the U.S.): Completed by a USCIS-designated civil surgeon using Form I-693
• Consular processing (overseas): Completed by a DOS-designated panel physician at a clinic near the consulate

You cannot use a regular doctor for either type.

What the exam covers

The immigration medical exam includes:

• Review of vaccination records against the CDC-required vaccine schedule
• Physical examination for communicable diseases of public health significance
• Mental and physical health history review
• Drug and alcohol screening in some cases

Vaccinations that are missing or out of date must be administered during the exam. CDC technical instructions control the vaccination requirements.

Adjustment of status: Form I-693 and the civil surgeon

For adjustment of status cases:

• Use only a USCIS-designated civil surgeon. Find one at the USCIS Find a Civil Surgeon tool
• The civil surgeon completes Form I-693 and seals it in an envelope
• Do not open the sealed envelope
• Submit the sealed I-693 with your I-485 or as directed in the current USCIS instructions
• Check current USCIS instructions for how long an I-693 remains valid

Consular processing: panel physician and the sealed envelope

For consular processing cases:

• Use only the panel physician clinic designated by your specific consulate. The list is post-specific
• Schedule the medical exam before your consular interview
• The panel physician provides a sealed envelope with the exam results
• Bring the sealed envelope to the consulate on interview day. Do not open it

For Ciudad Juárez, the exam must be completed at least 3 business days before the interview at an authorized clinic in México.

When prior medicals may be reused

Whether a prior immigration medical exam can be reused depends on:

• How much time has passed since the exam
• Whether CDC technical instructions have changed
• Current USCIS or DOS guidance on exam validity

Always check current official instructions before relying on a prior exam.

Dynamic items: verify with official sources

What can vary by case, post, or month

These notes come from the research module behind this guide. Use them as flags; verify official instructions for your case before relying on general guidance.

Clearly required

• a valid exam in the format required for the processing mode

Conditional

• timing, sealed-document or electronic transmission mechanics, and whether partial medical/vaccination documentation is acceptable

Dynamic (may change)

• CDC technical instructions and post-specific panel physician arrangements

Unresolved

• when prior medicals can be reused should always be checked against the current USCIS or DOS instructions