Preparing for the Immigration Medical Exam

In the marriage Green Card application process, all applicants are required to get the immigration medical examination. This is not a pass or fail exam but just for the U.S. government to determine that the marriage Green Card applicant is of good health and does not have health conditions that would deem them ineligible to receive a marriage Green Card.


Although the immigration medical exam process is rather simple, preparation for this medical exam can make the overall procedure straightforward and without any undue delay. Even if there may be some complications with the immigration medical examinations, there are avenues to request a waiver by filing Form I-601 (Application for Waiver of Grounds of Inadmissibility).

I. What do physicians check in the immigration medical examination?

In general, the following are performed during the immigration medical examination for the completion of Form I-693 (Report of Medical Examination and Vaccination Record):

  1. Review of communicable disease of public health significance
  2. Review of physical or mental disorders with associated harmful behavior
  3. Review of drug abuse or addiction
  4. Review of alcohol abuse or addiction
  5. Review of vaccination and immunization record
  6. Administering of any required tests for other diseases/illnesses.

II. Who can administer the immigration medical examination?

The immigration medical examination can only be performed by doctors authorized by USCIS. The authorized doctors are often referred to as civil surgeons. In certain situations involving U.S. veterans, U.S. military personnel or their designated dependents, authorized military personnel may be allowed to perform the immigration medical examination.

In cases where the immigration medical examinations must be performed outside of the United States and its territories, these examinations may be performed by a panel physician. These panel physicians are authorized and designated by the U.S. Department of State and the U.S. consulate offices rather than the USCIS.


III. What are the costs associated with the immigration medical examination?

The Green Card medical exam cost will vary depending on who performs these medical examinations. An average expected price can be about $200 per full medical examination.


IV. Where can I find an authorized doctor?

Finding a civil surgeon can be done by searching for your address at https://my.uscis.gov/findadoctor.

When searching for a panel physician, please consult the U.S. embassy or consulate office website.


V. When should I schedule the immigration medical examination?

The timing and scheduling process will differ depending on the situation of the marriage Green Card applicant and where the applicant resides.

  1. If the marriage Green Card applicant is applying while living in the United States:
    • Applicant may schedule prior to the application of the marriage Green Card through concurrent filing
      • Form I-693 is required to be completed and signed no more than sixty (60) days prior to submitting Form I-485 (Application to Register Permanent Residence or Adjust Status)
      • If Form I-693 is completed and signed more than sixty (60) days prior to submission of Form I-485, it is better to submit after submission of Form I-485
      • Alternatively, marriage Green Card applicant may bring a sealed copy of the medical examination to the marriage Green Card interview
    • Applicant may schedule after filing Form I-485
      • Form I-693 may be filed after filing Form I-485
      • Sealed copy of Form I-693 can be brought to the marriage Green Card interview

*Form I-693 validity: Form I-693 completed and signed by a civil surgeon is valid for two (2) years, so the marriage Green Card applicant should plan accordingly in order to not repeat the immigration medical examination.

  1. If the marriage Green Card applicant is applying while living outside of the United States:
    • Applicant should schedule after receipt of the marriage Green Card interview appointment letter from the National Visa Center (NVC)
      • Due to the longer wait time, the U.S. State Department explicitly indicates that immigration medical examinations should not be scheduled until receipt of the marriage Green Card interview appoint letter

*Form I-693 validity: Form I-693 completed and signed by a panel physician is valid for six (6) months, so the marriage Green Card applicant should plan accordingly in order to not repeat the immigration medical examination. Under certain circumstances where the marriage Green Card applicant has medical complications and conditions, the expiration of the immigration medical examination could be within three (3) months.


VI. What needs to be brought to the immigration medical examination?

  1. Form I-693 (Do not sign this until instructed to do so by civil surgeon or panel physician)
  2. Government issued photo identification
    • Valid passport
    • Driver’s license
    • Birth certificate
  3. Vaccination or immunization record
  4. Medical insurance card
  5. Payment for medical examination

If the marriage Green Card applicant suffers from any medical conditions or is currently under medical treatment, the applicant should provide supplemental medical records, previous diagnostics records, and/or documents of current medical treatment(s).

If the marriage Green Card applicant is applying outside of the United States, the applicant must also bring the marriage Green Card interview appointment letter from the National Visa Center (NVC)


VII. What happens right after the immigration medical examination?

After the completion of the immigration medical examination, the civil surgeon or the panel physician will have you sign and certify the Form I-693. Marriage Green Card applicants should not sign Form I-693 until instructed to do so.

If there are additional tests or medical examinations that need to be further completed, the civil surgeon or panel physician will require you to return for a follow up visit.

However, should the immigration medical examination be finalized, the civil surgeon or panel physician must provide you with a sealed envelope with a final copy to either submit with filings, or to bring to the marriage Green Card interview. If you wish to request a copy for your records, it is best that the request be made before the records are sealed in an envelope.


VIII. What health issues could result in a denial of the marriage Green Card application?

The main purpose of the immigration medical examination is to ensure that the marriage Green Card applicant will not be a health threat when entering the United States endangering other current residents. The following are certain conditions and health concerns that could lead to the denial of the marriage Green Card application:

  1. Having been diagnosed with a communicable disease
    • If you are diagnosed with certain communicable diseases outlined by the U.S. Centers for Disease Control (CDC), the marriage Green Card applicant may face denial until evidence of being cured or current treatment plan is provided
    • marriage Green Card applicant may be able to file a waiver form by filing Form I-601
  2. Having been diagnosed with a serious disease
    • Supplemental documentation from treating physician providing that the marriage Green Card applicant is managing the illness or is no longer affected by the condition may be required
  3. Having been diagnosed with drug abuse/addiction
    • marriage Green Card applicant may be required to complete a drug treatment program and provide a certification of completion
  4. Having been diagnosed with alcohol abuse/addiction
    • marriage Green Card applicant may be required to complete an alcohol treatment program and provide a certification of completion
  5. Having been diagnosed with physical or mental disorders with associated harmful behavior
    • History of drunk driving falls under this category
  6. Having been labeled as unable to physical work
    • marriage Green Card applicants diagnosed with severe degenerative or fatal diseases may be disqualified
    • marriage Green Card applicant should be able to be financially sufficient by being able to work

IX. What happens if a Form I-601(Application for Waiver of Grounds of Inadmissibility) waiver is filed?

If the marriage Green Card application is denied due to medical concerns, the applicant may file a Form I-601 to be granted a waiver. Once filed with the USCIS, the waiver form will be reviewed by the CDC and their regulations to determine whether the waiver should be granted. Alternatively, the CDC may suggest to the USCIS additional conditions to impose on the marriage Green Card applicant to cure the deficiency and grant the waiver.


X. What is an I-693 deficiency notice?

Have you received a notice from USCIS informing you that your Form I-485 Application to Adjust Status is “deficient” because a completed and signed Form I-693 was not submitted? The notice was sent just to remind you that you will need to submit a completed and signed Form I-693 Medical Exam to USCIS in the future, mostly at the adjustment of status interview.