Filing Form I-485 to adjust status to permanent resident requires a sealed medical exam (Form I-693) performed by a USCIS-designated civil surgeon. The exam is not done by a regular doctor: USCIS designates specific physicians and updates the list regularly. Since December 2024, USCIS requires I-693 to be submitted together with I-485, so scheduling early matters.
- What you need to bring: Government-issued photo ID, vaccination records (including childhood records translated to English if applicable), and prior medical history relevant to the panel exam.
- What the exam covers: Physical exam, vaccination review and any boosters required by USCIS, TB screening (IGRA blood test preferred over skin test), syphilis serology, and gonorrhea screening for applicants 18-24.
- Typical cost and timing: Costs range from approximately $200 to $500 depending on location and vaccines needed. Appointments can be booked several weeks out, especially in major metros, so plan ahead of your I-485 filing window.
Civil surgeon designation data from uscis.gov. Exam requirements from USCIS Policy Manual Volume 8, Part B. Not legal or medical advice.
Find Civil Surgeons Near You
Enter your ZIP code to see immigration doctors near you on the map, plus a link to the official USCIS directory.
What to Bring to Your Appointment
Tips to Save Time & Money
Costs vary widely — $200 to $500+. Ask about the total cost including vaccinations before your appointment.
As of updated USCIS guidance, Form I-693 does not expire as long as the benefit (e.g., I-485) it supports is still pending. No need to worry about the old 2-year rule.
CDC requires civil surgeons to conduct the physical examination in person — telemedicine is not allowed for immigration medical exams.
Having your records saves time and money. Without them, the doctor may need to re-administer vaccines or run blood tests.
The civil surgeon will give you a sealed envelope with your I-693. Do NOT open it — submit it sealed with your I-485.
Since March 2024, CDC requires an IGRA blood test (QuantiFERON or T-SPOT.TB) for all applicants 2+ years old. The old skin test (TST) is no longer accepted. Results typically take 1-3 days.
Required Vaccinations
CDC-required vaccinations for immigration. Age-appropriate — not all apply to every applicant.
Frequently Asked Questions
Related Resources
Understanding the I-485 Medical Exam
The immigration medical exam is a mandatory step in the adjustment of status process. Knowing what to expect can save time, money, and stress.
What is Form I-693?
Form I-693 is the Report of Medical Examination and Vaccination Record. A USCIS-designated civil surgeon must complete it after examining you. It is required for every I-485 (adjustment of status) application.
Timing Matters
The I-693 is valid for 2 years from the date the civil surgeon signs it, but must be signed no more than 60 days before filing I-485. Schedule your exam close to your filing date to maximize validity.
Required Vaccinations
USCIS requires proof of age-appropriate vaccinations including MMR, Tdap, Varicella, Hepatitis B, and seasonal flu (Oct-Mar only). Bring existing vaccination records to avoid unnecessary shots and extra costs.
Costs and Insurance
Civil surgeon exams typically cost $150-$400 depending on location and required vaccinations. Most health insurance does not cover immigration medical exams. Some civil surgeons offer payment plans.
Frequently Asked Questions
Information compiled from USCIS guidelines. This is not medical or legal advice. Consult your civil surgeon and immigration attorney for guidance specific to your case.