Immigration Physicals

For consular applicants, the National Visa Centre will tell you when it’s time to schedule the appointment. You will need to complete the medical exam and vaccinations before your scheduled immigrant visa interview date.

Adjustment of status applicants may have more flexibility. We prefers that our customers submit the exam results with the adjustment of status application package as part of a concurrent filing. In this way, the entire package of items is available to USCIS to quickly process. If you choose to follow this path, make an appointment with the civil surgeon before you begin the green card application process on Tran Urgent Care Wellness Centre. Submit the results with your Form I-485, Application to Adjust Status. Again, this improves the chances that USCIS can waive your interview and approval your green card as quick as possible.

Some adjustment applicants feel rushed to submit the application or prefer to do the immigration medical exam at a later time. If this is your path, schedule your exam soon after filing the I-485 application. Take the results with you to the green card interview or if USCIS issues a Request for Evidence letter that demands the exam results. Not filing the exam results with Form I-485 will generally result in longer processing times for applicants. USCIS generally will not waive an interview if you did not submit the medical exam results with the application.

When applying inside the U.S., the exam results are valid for a period of two years from the doctor’s signature date.

(UPDATE 4/4/2024: USCIS announced that any Form I-693, Report of Immigration Medical Examination and Vaccination Record, that was properly completed and signed by a civil surgeon on or after November 1, 2023, does not expire and can be used indefinitely as evidence to show that the applicant is not inadmissible on health-related grounds.)

The doctor will even perform a mental status exam that assesses your intelligence, thought, comprehension, judgment, affect, mood, and behavior. Applicants who have physical or mental disorders and harmful behavior associated with those disorders are inadmissible. The inadmissibility ground is divided into two subcategories:

• Current physical or mental disorders, with associated harmful behavior; and
• Past physical or mental disorders, with associated harmful behavior that is likely to recur or lead to other harmful behavior.

Effective October 1, 2021, most new green card applicants must be fully vaccinated for COVID-19. If not vaccinated, the U.S. government will consider them inadmissible to the United States. This applies to:

• Adjustment of status applicants inside the U.S.
• Consular processing applicants outside the U.S.

Immigration officials may require people to get revaccinated with an FDA-authorized vaccine if they initially received a COVID-19 vaccine not currently authorized in the U.S.

At the immigration medical exam, green card applicants must show the doctor evidence that they are fully vaccinated against COVID-19. Acceptable forms of proof include:

• Official vaccination record
• Copy of medical chart

The record should include the dates the applicant received the vaccine, and if available, the name or manufacturer and lot number.

Blanket waivers of the vaccination requirements (including COVID-19), may be applied if a vaccine is not medically appropriate or the vaccine is “not routinely available” in the country.

According to the USCIS Policy Manual, an immigration officer may grant a blanket waiver if the civil surgeon or the panel physician certifies that any vaccine is not medically appropriate for one or more of the following reasons:

• The vaccine is not age appropriate;
• The vaccine is contraindicated;
• There is an insufficient time interval to complete the vaccination series; or
• It is not the flu season, or the vaccine for the specific flu strain is no longer available.

They may also grant a blanket waiver in the case of a vaccination shortage or otherwise not routinely available in a country. However, if you are adjusting status to permanent resident, a U.S. doctor will perform your medical exam. Vaccines are widely available regardless of income, insurance or immigration status in the United States. Thus, blanket waivers are less likely to be granted.

Costs for immigration medical exams can vary significantly based on the country where it will be performed and the specific doctor. Prices can vary from $100 to over $400. The U.S. government doesn’t set a standard fee. The cost will depend on the doctor you visit. Therefore, check with a few doctors to find out how much each one charges for the immigration medical exam.

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

You won’t be able to go to any doctor for your immigration medical exam. The examination must be performed by a government-approved doctor. Outside the United States, the U.S. embassy or consulate will refer you to a “panel physician.” Applicants applying inside the United States will go to a “civil surgeon.” In both situations, they are doctors authorized to provide your exam.

If you are applying for an immigrant visa through a U.S. embassy or consulate (known as consular processing), they will provide a list of panel physicians who have been certified by the Department of State. In most cases, you’ll have a choice of physicians. But it’s always best to check with the procedure at your local consulate. You may need to have your appointment notification before the panel physician will see you.

For adjustment of status cases, you must attend an examination with a civil surgeon in the United States. A directory of civil surgeons is also available.

In preparation for the medical examination, you will need to take several items. This list will vary based on the location of your exam. If you are attending an exam outside the United States, the U.S. embassy will give you specific guidance for your country. However, you will generally need to take the following items to an immigration medical exam:

• Valid passport or other government-issued photo identification
• Vaccination records
• Form I-693, Report of Medical Examination and Vaccination Record (if adjusting status)
• The required fee (varies by doctor)
• Required number of U.S. passport photos (if applying abroad – check with consular office)
• Report of the condition and any special education or supervision requirements (if anyone in your family is immigrating with learning disabilities)
• List of medications (if you are being treated for a chronic medical condition or taking medications on a regular basis)
• Tuberculosis certificate from your doctor (if you’ve had a previous positive skin test for tuberculosis) proving that you were adequately treated
• Certificate of clearance signed by a doctor or public health official, proving that you were adequately treated (if you have had syphilis)
• If you have a history of harmful or violent behavior resulting in injury to people or animals, information that will allow the doctor to determine whether the behavior was related to a psychiatric or medical problem, or to drug or alcohol use
• If you have been treated or hospitalized for psychiatric or mental illness, or alcohol or drug abuse, written certification including the diagnosis, length of treatment, and your prognosis

The doctor will make sure that you have had all the required vaccinations. Some vaccines are expressly required by the Immigration and Nationality Act, and others are required because the Centres for Disease Control and Prevention (CDC) have determined they are in the interest of public health. Regardless, you must receive the following vaccinations before being admitted as a permanent resident:

• Mumps, measles, rubella
• Polio
• Tetanus and diphtheria toxoids
• Pertussis
• Haemophilius influenza type B
• Hepatitis B
• Varicella
• Influenza
• Pneumococcal pneumonia
• Rotavirus
• Hepatitis A
• Meningococcal
• COVID-19 (See details below)

At the time of publishing this article, the list above is complete. However, new vaccinations may be added to the list over time. Not everyone requires all the vaccinations. USCIS maintains a chart of vaccinations that are considered medically appropriate by age.

If you already have some or all vaccinations, take your vaccination reports to the doctor. The report will need a certified translation if it is not already in English. If you haven’t been vaccinated, the doctor will administer them. Depending on the type of vaccination, an additional visit may be required. Upon the recommendation of the physician, they may provide certain waivers of the vaccination requirement.

For new immigrants who do not want to be vaccinated or cannot obtain a vaccine for certain reasons, there may be a waiver. However, you must meet the specific requirements, and it will take some effort. There are essentially two types of waivers: blanket waivers and religious/moral waivers. When USCIS grants blanket waivers, the applicant does not have to file a form or pay a fee. However, applicants must file a form and pay a fee when applying for a waiver on account of religious or moral objections. There is also no guarantee USCIS will grant the waiver. Carefully consider your desire to obtain a waiver.​

Immigrants may also apply for individual waivers based on religious beliefs or moral convictions. Immigration officials will only grant the vaccine waiver if the individual is opposed to all vaccinations (not just certain ones) and if the opposition is based solely on religious or moral convictions. There is no waiver for the COVID-19 vaccine available based on scientific arguments or political beliefs.

The waiver of an immigrant vaccination requirement must satisfy three requirements. The applicant must be able to corroborate these three facts with documentary evidence. For this reason, it’s best to seek the assistance of an immigration attorney if you need the individual waiver for vaccines. Your waiver must satisfy all three of the following requirements:

• You must be opposed to all vaccinations in any form;

You must demonstrate that you oppose vaccinations in all forms. Your objection cannot be limited to the a single vaccination such as the COVID-19 vaccination. If you received certain vaccinations but not others, it is not automatic grounds for the denial of a waiver. However, it will be difficult to overcome. Policy requires the USCIS officer to consider the reasons provided for having received those vaccines.

For example, an applicant’s religious beliefs or moral convictions may have changed substantially since the date the particular vaccinations were administered, or the applicant is a child who may have already received certain vaccinations under the routine practices of an orphanage. These examples do not limit the officer’s authority to consider all credible circumstances and accompanying evidence.

• Your objection must be based on religious beliefs or moral convictions; and

USCIS officers are trained to handle this area with sensitivity. They must balance the merits of your religious beliefs against the benefit to society as a whole.

• The religious belief or moral conviction must be sincere.

You must demonstrate that you hold the belief sincerely. Even if these beliefs accurately reflect your ultimate conclusions about vaccinations, they must stem from religious or moral convictions, and must not have been framed in terms of a particular belief so as to gain the legal remedy desired, such as this waiver. The belief may not be political or scientific in nature.

Be prepared to cite the source of your religious beliefs or document past decisions affected by your moral convictions. However, you do not need to be a member of a recognized religion or attend a specific house of worship.