In general, a Form I-485 applicant must complete an immigration medical examination, and some applicants need only its vaccination portion (USCIS). USCIS says the immigration medical examination must be performed by certain doctors designated by USCIS, known as civil surgeons, and its Find a Civil Surgeon tool lists them. Since Dec. 2, 2024, a required Form I-693 must be submitted with Form I-485 (uscis.gov/i-693).
- 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 exam.
- What the exam covers: Medical history (including questions about drug and alcohol use and psychiatric history), a physical exam that includes a mental status evaluation, review of the vaccinations the CDC requires for your age, a TB blood test (IGRA) for applicants 2 years of age and older with a chest x-ray when required, syphilis testing for applicants aged 18 to under 45, and gonorrhea testing for applicants aged 18 to 24 (CDC Technical Instructions for Civil Surgeons).
- Cost: USCIS says fees for immigration medical examinations are established by the civil surgeon and may vary by civil surgeon (uscis.gov/i-693). Ask the civil surgeon for the total cost, including any vaccinations.
Civil surgeon designation data from uscis.gov. Exam requirements from the USCIS Policy Manual (Vol. 8, Part B) and the CDC Technical Instructions for Civil Surgeons, read October 21, 2026. Not legal advice. Not 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
USCIS says fees for immigration medical examinations are established by the civil surgeon and may vary by civil surgeon (uscis.gov/i-693). Ask the civil surgeon for the total cost, including any vaccinations.
Since June 11, 2025, USCIS policy is that Form I-693 is generally valid only for the immigration benefit application it was submitted with, while that application is pending. A form a civil surgeon signed before November 1, 2023 retains evidentiary value for 2 years from the signature date, so every such form reached that 2-year mark before November 1, 2025 (USCIS Policy Manual, Vol. 8, Part B, Ch. 4).
USCIS says that, according to the CDC, civil surgeons cannot perform an immigration medical examination using telemedicine and must conduct the physical examination in person.
Without records, the civil surgeon may need to re-administer vaccines or test your immunity with blood titers.
The civil surgeon must give you the signed Form I-693 in a sealed envelope. If you file Form I-485 by mail, submit Form I-693 in that original sealed envelope. If you file online, USCIS says to open the envelope, upload the form, and keep the original form and envelope until USCIS makes a final decision on your I-485. If USCIS rejects your package and returns it with the Form I-693 envelope opened, USCIS says you may include that original opened Form I-693, in its original envelope, with a copy of the rejection notice in a new package (uscis.gov/i-693).
Under the current CDC Tuberculosis Technical Instructions for Civil Surgeons (this edition took effect March 11, 2024), applicants 2 years of age and older must have an interferon-gamma release assay (IGRA), a blood test, unless they have a physician's written documentation of a previous positive IGRA. A tuberculin skin test (TST) can be used only in children under 2 when indicated. A chest x-ray is required after a positive IGRA, with known HIV infection, or with signs or symptoms of TB disease.
Required Vaccinations
CDC-required vaccinations for immigration (CDC Technical Instructions for Civil Surgeons). They are age-appropriate, so not all apply to every applicant.
Frequently Asked Questions
Related Resources
Understanding the I-485 Medical Exam
The immigration medical exam is generally a required 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 Immigration Medical Examination and Vaccination Record. You complete Part 1. The civil surgeon, and any other doctors, clinics or health departments you are referred to, complete the remaining parts (Form I-693 instructions). In general, a Form I-485 applicant must complete an immigration medical examination, and some applicants need only its vaccination portion (USCIS).
Validity and Filing
Form I-693 is generally valid only for the application it is submitted with (USCIS Policy Manual, Vol. 8, Part B, Ch. 4). Since Dec. 2, 2024, a required Form I-693 must be submitted with Form I-485.
Required Vaccinations
The CDC requires proof of age-appropriate vaccinations or immunity, including measles, mumps, rubella, diphtheria, tetanus, pertussis, varicella, hepatitis B, and influenza (required when available in the United States). Bring existing vaccination records to avoid unnecessary shots and extra costs.
Costs and Insurance
USCIS says fees for immigration medical examinations are established by the civil surgeon and may vary by civil surgeon (uscis.gov/i-693). USCIS notes that many health insurance plans do not cover all portions of the exam. Ask the civil surgeon for the total cost, including any vaccinations.
Frequently Asked Questions
Information compiled from USCIS (uscis.gov/i-693 and the USCIS Policy Manual, Vol. 8, Part B, Ch. 4) and the CDC Technical Instructions for Civil Surgeons, read October 21, 2026. Not legal advice. Not medical advice. Consult your civil surgeon and immigration attorney for guidance specific to your case.