U.S. immigration medical exams, commonly called a green card medical checkup, are a required step for many applicants seeking lawful permanent residence. Conducted by a government-approved civil surgeon, the exam screens for public health risks, ensures vaccine compliance, and verifies document accuracy. This overview outlines who needs the exam where to get it what tests are performed costs what to bring and what happens after the visit. The guidance below reflects long standing policies and procedures that apply broadly across petition types and does not address rare time-sensitive scenarios.
Who Must Complete a Medical Exam
You must obtain an immigration medical exam when applying for a green card through adjustment of status or consular processing abroad if you:
- are applying for permanent residence based on family employment or diversity visa categories;
- have been granted asylum or are applying for withholding of removal;
- are a derivative applicant or child turning age 15 or older at the time of interview;
- have spent time in regions where certain diseases are common or have symptoms that raise public health concerns.
Check the latest guidance on the USCIS and CDC websites because rules can change for specific countries or circumstances.
Where to Get the Exam
Civil Surgeons in the United States
If you are in the United States, the exam must be performed by a designated civil surgeon listed on the USCIS website. These physicians are licensed to perform immigration-related medical examinations and follow standardized forms and procedures. You can search for a civil surgeon by city or zip code on the USCIS immigration medical exam page. Primary care physicians typically do not perform these exams unless they have been certified as civil surgeons.
Panel Physicians Abroad
If you are outside the United States, you must complete the exam with a panel physician authorized by the U.S. Department of State. The panel physician process is used during consular processing at U.S. embassies or consulates. Find an appointed doctor through the CEAC website by entering your country and embassy or consulate location. Note that civil surgeons inside the United States cannot perform exams for applicants living abroad.
Required Tests and Procedures
| Test or Component | Verified Detail | Source Type |
|---|---|---|
| Physical examination | Complete head-to-toe assessment for infectious diseases and physical conditions | USCIS Medical Examination Guidelines |
| Tuberculosis (TB) testing | Chest X-ray for adults; TB skin test or IGRA for children under certain ages | CDC Tuberculosis Screening Requirements |
| Vaccination review and updates | Measles mumps rubella (MMR) diphtheria tetanus pertussis polio varicella influenza type B hepatitis A and B as indicated | CDC Vaccine Schedule for Immigrants |
| Blood tests | Syphilis serology; HIV testing may be required based on country or age | USCIS Infectious Disease Panel |
| Parasitology stool sample | Ova and parasite exam for candidates from or with travel to endemic areas | CDC Parasite Diagnostic Guidelines |
| Administrative review | Confirmation of identity age and document accuracy | USCIS Policy Manual |
What to Bring to Your Appointment
- Valid government-issued photo ID such as a passport or driver’s license;
- Original vaccination records if available USCIS form I-693 will be used to record immunizations;
- Any prior medical records that show treatments for chronic conditions or communicable diseases;
- Completed USCIS Form I-693 if you are applying within the United States and your civil surgeon will sign and seal it;
- Passport-style photographs if required by the civil surgeon or embassy;
- Payment for the exam fee and any laboratory charges in accepted local currency or method.
Costs and Timeline
The total cost varies by provider region and required tests. In the United States fees typically range from about 200 to 600 USD or more depending on laboratory and vaccine needs. For applicants abroad costs depend on the country and specific panel physician. Appointments may fill quickly so book early. Results are usually provided directly to the civil surgeon or panel physician who then forwards the sealed report to USCIS or the consulate. Processing times for the medical examination itself are commonly a few weeks but can be longer in high demand locations.
Common Conditions and Outcomes
The exam focuses on health issues that could pose a risk to public safety or burden public resources. Conditions that often require attention include active tuberculosis untreated syphilis HIV in certain age groups under some country rules and insufficient vaccination coverage. If a condition is identified your physician will advise treatment and may require a follow-up exam or laboratory evidence of cure or immunity. Most applicants who complete standard testing and receive recommended vaccinations or treatments proceed without delay. Minor abnormalities that do not meet public health thresholds typically do not result in a denial.
Next Steps After the Exam
Once your civil surgeon or panel physician completes the exam:
- They will submit the sealed medical report through official channels to USCIS or the consulate.
- You should not open the sealed envelope or attempt to submit the report yourself.
- Continue with other application steps such as filing forms paying additional fees and attending interviews.
- If additional evidence is requested respond promptly and through official channels.
Because policies and lists of required vaccines can update, revisit the official USCIS CDC and Department of State resources shortly before your appointment to confirm current requirements.