What the Medical Exam for a U.S. Green Card Involves

Passing a medical exam is an important part of showing that you are not inadmissible to the U.S. and can be issued an immigrant visa or green card.

By , J.D., University of Washington School of Law

As a test of whether you fall into a health-related ground of inadmissibility, any application for U.S. permanent residency (meaning an immigrant visa through a U.S. consulate overseas or a green card through adjustment of status in the U.S.) or for a K-1 fiancé visa will include a medical exam. This requirement applies to both adult and child applicants (though the exam doctor will take age into account for purposes of things like deciding which vaccines are necessary). Here, we'll discuss:

  • how to arrange for the immigration medical exam
  • what to bring with you for the medical exam
  • what issues the physician is looking for
  • vaccines you will need to receive before or during the medical exam
  • what happens during the medical exam, and
  • validity period for the medical exam results.

Where to Find a Doctor to Prepare Your Immigration Medical Exam Report

Your own personal doctor cannot do the exam unless they happen to be on the government's list of approved physicians. You will need to pay the fee for the exam. The U.S. government does not control how much the doctor can charge.

If you're in the United States, the doctors who can do your medical exams are known as "civil surgeons." A list of these doctors is available on the Find a Civil Surgeon page of the USCIS website. You can also get this information by calling the USCIS Contact Center at 800-375-5283.

The U.S. doctor must fill out a USCIS Form called an I-693 in order to report the results of your exam. The doctor will give you your results in a sealed envelope.

If you are overseas and applying through a U.S. consulate, the doctor is known as a "panel physician." To find one, check with the embassy or consulate handling your visa application or find its online instructions. The fee varies among doctors, so you might want to call a few before choosing one. Overseas doctors fill out a form called DS-2054, and either put it in a sealed envelope for you to deliver or send your results directly to the consulate.

What to Bring to the Appointment for an Immigration Medical Exam

You will need to bring along to the doctor's office:

  • Exam fee; typically between $130 and $450 in the United States. If you are in the United States, also bring your medical insurance card (some doctor's offices can obtain coverage of the fee from your medical plan).
  • Copies of prior medical records, immunization or vaccination records, and chest X-rays (if you've had any).
  • If you're ever had a positive skin test for tuberculosis, a certificate from your attending doctor describing the circumstances, treatment, and its duration; or if you have ever been diagnosed with tuberculosis, a signed certification from your attending doctor indicating that you were adequately treated.
  • If you've been treated or hospitalized for psychiatric or mental illness or alcohol or drug abuse, written certification from your doctor including the diagnosis, duration of treatment, and prognosis.
  • If you're being treated for any chronic medical conditions, or taking regular prescription medications, a list of diagnoses and medication names, or a doctor's certificate describing these along with the current treatment plan and prognosis.
  • If you have an intellectual or learning disability, present a professional report describing your condition and any special educational or supervision requirements.
  • Government-issued photo identification, such as a valid passport, driver's license, laissez-passer, or travel document.
  • If you are coming from overseas, a copy of your consular interview appointment notice.
  • If you are coming from overseas, a copy of your "Immigrant Visa and Alien Registration Application" confirmation page.
  • Passport photos—how many depends on where you're applying from.
  • If applying in the U.S. via the process known as adjustment of status, a printed copy of USCIS Form I-693. (Yes, the doctor's office likely will have these on hand, but by bringing one along that you've recently printed out, you'll make sure they're using the latest acceptable version.)

Be sure to check any instructions from the physician's office in case these requirements have been added to or changed.

What Medical Issues the Immigration Panel Physician Is Looking For

This is not like a regular physical exam or check-up, where you bring up health issues that you are experiencing and receive wide-ranging medical advice or diagnoses. It is more of a screening exam, to see whether it is safe to allow you into the United States. You don't have to be in perfect health, but you must not have any serious or communicable diseases, mental disorders, or drug problems.

The first thing the doctor's office will do is check your passport or other identity document, to make sure that you are really you, and that you haven't sent a healthier person in your place.

Diseases and Conditions That Lead to Inadmissibility

If you are applying to adjust status in the U.S., the diseases that can make you inadmissible (as of 2024) are gonorrhea, infectious leprosy (Hansen's disease), infectious stage syphilis, and active tuberculosis (TB).

If you are seeking an immigrant visa at a U.S. consulate, two more types of disease can make you inadmissible:

  • certain diseases that might make you subject to quarantine (recently including cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and novel or reemergent influenza (pandemic flu including the COVID-19 coronavirus), as well as
  • certain diseases that could pose a public health emergency of international concern when there's a threat that you'll bring that disease to the U.S. and the disease could affect the health of the American public.

See Chapter 6 of the USCIS Policy Manual for details and updates.

Although HIV is no longer a ground of inadmissibility, be sure to read "Human Immunodeficiency Virus (HIV) and U.S. Immigration."

If you have an illness that causes you trouble but will not infect or injure others, such as heart disease, cancer, or certain mental illnesses, you will not be inadmissible on medical grounds. However, it's possible you could be found inadmissible as a likely public charge—that is, someone who will probably require need-based government assistance (often referred to as welfare)—if you will not be able to work in the U.S. and don't have medical insurance.

Vaccination Requirements

A further requirement of getting a U.S. green card is that you have had certain vaccinations, unless the physician finds them medically inappropriate for you (for instance, because of age or pregnancy) or you successfully apply for a waiver of this requirement. The list of those vaccinations is below.

(You might also wish to see Green Card Applicants' Options for Refusing COVID-19 Vaccination Requirements.)

If you are entering the U.S. on a K-1 fiancé visa, however, the consulate might give you a choice of either getting these vaccines as part of the medical exam you get for your fiancé visa, or as part of the medical exam you get in the United States after you are married and apply for your green card.

Refugees and people granted asylum in the U.S. do not need the vaccinations until they apply for a green card.

Vaccinations You and Your Children Must Have to Avoid Inadmissibility

In 2024, the required vaccinations according to guidance from the Centers for Disease Control (CDC) included the ones listed below. Some of these are required only for people in certain age groups. If other diseases later become preventable by vaccines, they could be added to this list in the future.

  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Rotavirus
  • Haemophilus influenzae type b (Hib)
  • Hepatitis A
  • Hepatitis B
  • Meningococcal disease
  • Varicella
  • Pneumococcal disease
  • Influenza (flu), and
  • COVID-19 (unlike other vaccines, the full series must be completed before the physician completes the medical exam report).

As an alternative to vaccination, where you've already had the disease in question, the doctor can use a U.S.-government-approved test kit to check whether you developed antibodies for it. If so, you have won't be required to get the vaccination. (You are said to have "laboratory-confirmed immunity.") This only works for these diseases, however:

  • measles
  • mumps
  • rubella
  • hepatitis A
  • hepatitis B
  • polio, and
  • varicella.

Bring along to your exam a copy of any past vaccination reports; the doctor will not be able to accept your word for the fact that you've had them done. If the vaccination reports are not in English, you will also need to bring a written, full English translation.

If you haven't had certain vaccines, the doctor will administer them (or at least the first dose) during this exam. However, the physician will not simply give the same set of vaccines to everyone. The exact nature of the requirement depends on which vaccines are considered age-appropriate, in the judgment of the Advisory Committee on Immunization Practices (ACIP).

You can view a chart of which vaccines are considered medically appropriate at various ages in the U.S. Citizenship and Immigration Services (USCIS) Policy Manual under Chapter 9, Vaccination Requirement.

As you'll see, infants five weeks old and younger are required only to have the Hepatitis B vaccination. A child who has reached seven weeks of age must also have the rotavirus vaccine.

What Happens During the Immigration Medical Exam

The doctor or a member of the doctor's professional staff will ask you for your medical history. The doctor will review all the times you have ever been in the hospital, any time you had to be put in an institution for a chronic physical or mental condition, and all the times you've ever been sick or disabled so seriously that it resulted in a "substantial departure from a normal state of well-being or level of functioning."

The doctor will ask specific questions about psychoactive drug and alcohol use. (You might want to also read, Can a Recovering Drug Addict Get a U.S. Visa or Green Card?.)

In addition, the doctor will ask about any history of any history of harmful behavior or any psychiatric illness not documented in the medical records. The doctor will also review chest X-rays and treatment records to see if you have or ever had tuberculosis.

The doctor will review any other records, such as police, military, school, or employment records, that might help to determine a history of harmful behavior related to a physical or mental disorder. These records also might show whether you have any illnesses or disabilities that result in a substantial departure from a normal state of well-being or level of functioning.

The doctor will ask specifically about symptoms that suggest cardiovascular, pulmonary, musculoskeletal, and neuropsychiatric disorders, and will look for symptoms that you are infected with any of the diseases that make someone inadmissible.

The doctor will then give you a physical examination, which will include looking at your eyes, ears, nose and throat, extremities, heart, lungs, abdomen, lymph nodes, skin, and external genitalia. The doctor will also perform a mental status examination, assessing your intelligence, thought, comprehension, judgment, affect, mood, and behavior.

The doctor will do any test necessary to diagnose—or confirm a suspected diagnosis of—diseases that could make you inadmissible. A blood draw and chest X-rays are usually part of the testing. You do not need to fast (refrain from eating) in preparation for the blood draw.

If you're too sick at the time of the medical exam for the doctor to perform all the necessary tests, you'll be referred to your own doctor to get better, and told to come back for the immigration medical exam later.

If your case is unusual and the doctor can't say for sure whether you can pass the medical exam, the doctor can refer you to another doctor to perform further testing.

When the examination is done, the doctor will prepare a form with results and findings. The doctor will give you the form in a sealed envelope for you to give the consulate or to USCIS (don't open the envelope!). In some cases when you are applying for a visa overseas, the doctor will send the results directly to the consulate.

How Long Your Immigration Medical Exam Results Are Valid

Timing is important. Someone's medical condition can change over the months and years that they might wait to be approved for a green card, and the U.S. government naturally wants the most up-to-date information.

If you're overseas, you will be instructed to go for the medical exam shortly before your visa interview. The results are normally considered valid for only six months.

If you're adjusting status from within the U.S., the results of the exam will then normally be good for two years after it's submitted. Realize, however, that USCIS can always order you to have a later exam done if it suspects you've since developed a medical ground of inadmissibility.

It is possible to file an adjustment application before getting the medical exam, and then bring the results of the exam to your adjustment interview, or submit them by mail if USCIS sends you a Request for Evidence (RFE). This can be a safer approach, so as to avoid the possibility that you'll get the exam done in anticipation of filing your adjustment application but the actual filing gets delayed. Many applicants successfully use this strategy.

Getting Legal Help

For personalized assistance with applying for lawful permanent residence, including consulting on issues concerning the medical exam, speak with an experienced immigration attorney.

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