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How is an immigration physical and how to prepare for it

Immigration medical examination is a necessary part of immigration to the United States and obtaining permanent resident status (obtaining a green card), including after winning the lottery. Medical examination is a routine part of the process to ensure public safety and to eliminate grounds for inadmissibility of future immigrants. More details about the medical examination process were told by the publication CitizenPath.

Photo: Shutterstock

Certain diseases of public health concern make a person unacceptable to enter the United States. This can prevent the applicant from obtaining a green card. Inspection is the process of removing these bases. It is important to know what to expect and how to prepare for your medical examination.

Purpose of Immigration Medical Examination

Medical grounds for inadmissibility, medical screening of foreign nationals, and vaccination of foreign nationals are all designed to protect the health of the United States population. The Immigration Medical Examination, Final Medical Examination Report, and Vaccination Record provide information that the United States Citizenship and Immigration Services (USCIS) uses to determine whether a foreign national meets medical eligibility standards.

Any of these four major medical conditions can render the applicant unacceptable for health reasons:

  • Infectious disease of public health importance
  • Immigrant Failure to Provide Proof of Necessary Vaccinations
  • Physical or mental disorder associated with behavior
  • Drug abuse or addiction

An immigration medical examination is not a complete medical examination. Its purpose is to check for certain medical conditions related to US immigration law. The US government does not require a doctor to examine you for any conditions other than those identified by the US Public Health Service for US immigration purposes. Likewise, the government does not require a doctor to prescribe a diagnosis or treatment for you, even if he or she discovers other health problems. This examination is not a substitute for a complete physical examination, consultation, diagnosis, or treatment with your healthcare professional.

On the subject: How to Recognize Immigration Fraud and Protect Yourself: USCIS Recommendations

Choosing a doctor for examination

You will not be able to choose a doctor for your immigration medical examination. The examination must be carried out by a physician authorized by the state. Outside the United States, they will be referred to as "Physicians" at the US Embassy or Consulate. Applicants applying in the US will go to a “civil surgeon”. In both cases, they are doctors who are authorized to carry out your examination.

If you are applying for an immigrant visa through the US embassy or consulate (this is called consular processing), they will provide a list of group doctors who have been certified by the State Department. In most cases, you will have a choice of doctors. But it's always best to check with your local consulate for the procedure.

When to make an appointment for a medical examination

The National Visa Application Center will advise you when it is time to make an appointment. You will need to undergo a medical check-up and vaccinations prior to your scheduled immigrant visa interview date.

Some status adjustment applicants choose to have an immigration medical examination later. If this is your way, schedule an inspection shortly after submitting your I-485 application. Take your results with you to your green card interview.

When applying in the United States, the results of the examination must be signed by the physician no later than 60 days before the Form I-485 is filed. Results are valid for two years from the date of signing.

What to take with you for a medical examination

When preparing for your physical exam, you will need to grab several items. This list will depend on the location of the inspection. If you are going to be screened outside the United States, the US Embassy will give you specific guidance for your country. However, as a rule, you need to bring the following items for the immigration medical examination:

  • A valid passport or other government-issued photo ID.
  • Vaccination records
  • Form I-693, Medical Examination Report and Vaccination Records (When Status Changes)
  • Required fee (depends on the doctor)
  • The required number of photos for a US passport (when applying abroad - check with the consulate)
  • Status report and any special education requirements
  • Medication List (if you are being treated for a chronic condition or are taking medication on a regular basis)
  • A certificate of tuberculosis from your doctor (if you have previously tested positive for tuberculosis) confirming that you received adequate treatment
  • Certificate of clearance signed by a physician or public health worker confirming that you have received adequate treatment (if you have had syphilis)

If you have a history of violent behavior that results in injury to people or animals, information to help your doctor determine if your behavior was related to psychiatric or medical problems, or to drug or alcohol use.

If you have been treated or hospitalized for a mental or mental illness, alcohol or drug abuse, a written statement indicating the diagnosis, duration of treatment, and your prognosis.


Your doctor will make sure you get all the vaccinations you need. Some vaccines are explicitly required by the Immigration and Citizenship Act, while others are required because the Centers for Disease Control and Prevention (CDC) has determined they are in the public health interest. However, you must receive the following vaccinations before becoming a permanent resident:

  • Mumps, measles, rubella
  • Polio
  • Tetanus and diphtheria toxoid
  • Pertussis
  • Haemophilius influenza type B
  • Hepatitis B
  • Chickenpox
  • Flu
  • Pneumococcal pneumonia
  • Rotavirus
  • Hepatitis A
  • Meningococcus

Over time, new vaccinations may be added to the list. Not everyone needs all vaccinations. USCIS maintains a chart of vaccinations that are considered medically acceptable for age.

If you have already had some or all of your vaccinations, take your vaccination report back to your doctor. A certified translation will be required for the report if it is not already in English. If you have not been vaccinated, your doctor will prescribe them. An additional visit may be required depending on the type of vaccination. On the recommendation of a doctor, he or she can grant specific waivers for vaccinations.

You may be interested in: top New York news, stories of our immigrants and helpful tips about life in the Big Apple - read it all on ForumDaily New York.

Vaccination against COVID-19

As of this writing, the US government does not require COVID-19 vaccinations as part of the immigration process. However, US government agencies are likely to deny you entry if you have:

  • Any symptoms of COVID-19, including a recent cough, fever, difficulty breathing, changes in smell or taste, or fatigue (this list is not exhaustive).
  • Have been in close contact with someone known or suspected of having COVID-14 in the past 19 days
  • Received a self-isolation or quarantine order from a healthcare provider, public health authority, or government agency within the past 14 days
  • We passed the COVID-19 test and are still waiting for the results.
Disease history

The doctor or member of the healthcare team will ask questions about your medical history. The doctor is especially interested in any time you:

  • Stayed in the hospital or experienced important events in their medical history;
  • Are placed in a medical institution with a chronic physical or mental illness;
  • They were so seriously ill that it resulted in "a significant deviation from the normal state of well-being or level of functioning."

The doctor will also ask specific questions about drug use. Applicants who are found to be drug addicts are not accepted. However, recovering addicts who are in remission are acceptable. Likewise, if the applicant is classified as a drug addict, he can reapply for permanent residence if his or her drug abuse or addiction is in remission.

If you have a history of drug abuse, even if it is not on your medical records, consult an immigration attorney before undergoing a green card medical examination.

Physical examination

The doctor will then conduct a physical examination. Usually, a physical exam includes examining your eyes, ears, nose and throat, limbs, heart, lungs, abdomen, lymph nodes, skin, and external genitalia. The doctor will also order a chest x-ray and blood test to check for syphilis. Children are usually exempted from x-rays and blood tests. If you are pregnant, contact your embassy or consulate.

Psychological examination

The doctor will even do a mental health exam that will assess your intelligence, thinking, understanding, judgment, affect, mood, and behavior. Applicants with physical or mental disorders and aggressive behavior associated with these disorders will not be accepted. Grounds of inadmissibility fall into two subcategories:

Current physical or mental disorders associated with violent behavior.

On the subject: Three features of life in the United States that infuriate immigrants

Past physical or mental health problems associated with harmful behavior that may recur or lead to violent behavior.

Immigration medical examination cost

The cost of an immigration medical examination can vary significantly depending on the country in which it will be performed and on the specific doctor. Prices can range from $ 100 to $ 400. The US government does not set a standard fee. The cost will depend on the doctor you visit. Therefore, check with several doctors to find out how much each of them charges for an immigration medical examination.

You may also need to consider indirect costs. In some cases, you may need to travel to the interview city early for a medical examination.

Upon completion

What happens after the test depends on your location.

In some countries, an expert doctor sends the results directly to the US Embassy. In other countries, the doctor will give the applicant the results of the medical examination in a sealed envelope and an X-ray, which the applicant must take for an interview.

If your immigration medical examination is conducted within the United States, the civil surgeon will give you a completed Medical Examination Report and Vaccination Records Form I-693 in a sealed envelope. Do not open the envelope under any circumstances. Submit your physical examination along with your Form I-485, Status Adjustment Application.

If you have already applied for a change of status, submit an envelope for your USCIS green card interview. The results of your immigration medical examination are usually valid for two years.

Read also on ForumDaily:

How to get back your permanent resident status if you have lost it due to travel abroad

How to Recognize Immigration Fraud and Protect Yourself: USCIS Recommendations

US citizenship: how long do immigrants wait for naturalization

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