No, you do not need a referral from your primary care doctor or an immigration attorney to see a civil surgeon for your immigration medical examination in 2026. You can schedule directly with a USCIS-designated civil surgeon. A referral is not required, but you still need identification, your available medical and vaccination records, and the examination needed to complete Form I-693, Report of Immigration Medical Examination and Vaccination Record.
- Do I need a referral for a civil surgeon? No. USCIS allows you to arrange your immigration medical exam directly.
- A primary care doctor can provide records, but only an authorized civil surgeon can complete your examination.
- ImmigrationMedicalExams.com provides Form I-693 immigration medical exams in Costa Mesa; a doctor's referral is not required.
- A referral for follow-up testing during your examination is different from a referral to book your appointment.
Do I need a referral for a civil surgeon?
You can book your Form I-693 examination without a doctor's referral, an attorney's recommendation, or a USCIS appointment assignment. USCIS instructs applicants who need a domestic immigration medical examination to find an authorized civil surgeon and arrange the visit themselves.
Start by confirming that the doctor performs immigration medical examinations as a USCIS-designated civil surgeon. A medical license alone does not authorize a doctor to complete this examination. The green card medical exam guide explains the broader process.
Several people can help you prepare, but their roles differ:
| Person or organization | What they do | What they do not replace |
|---|---|---|
| USCIS-designated civil surgeon | Performs the immigration medical examination and completes Form I-693 | Your attorney's advice about filing your application |
| Primary care doctor | Provides health records, vaccination documentation, and ongoing care | The civil surgeon examination, unless the doctor also holds the required designation |
| Immigration attorney | Helps coordinate timing and explains case-specific filing needs | Medical testing, vaccination review, or the civil surgeon's signature |
| USCIS | Sets immigration filing requirements and reviews submitted evidence | Your responsibility to arrange an examination when required |
A recommendation can help you choose a clinic. It is not permission you must obtain before scheduling.
Why this matters
Waiting for an unnecessary referral adds another task without helping the civil surgeon complete your examination. Your preparation matters more: accurate identification, usable vaccination records, and relevant medical documentation help the clinic determine what you need.
The practical distinction is between permission to book and information needed to finish. You do not need the first, but the civil surgeon still needs enough information to complete your Form I-693 accurately.
For example, a letter saying that you are generally healthy does not replace the required examination. A dated vaccination record, however, gives the civil surgeon information that can help document your vaccination history.
What do USCIS and CDC requirements mean in 2026?
USCIS determines who can perform a domestic immigration medical examination and provides the Form I-693 instructions. CDC's Technical Instructions for Civil Surgeons govern the medical screening and vaccination assessment. Neither makes a primary care referral a routine prerequisite for scheduling.
The examination is not simply a signature on a form. The civil surgeon reviews your medical history, conducts the required examination, evaluates vaccination documentation, and arranges testing under the applicable instructions.
Age affects some requirements. For example, CDC's tuberculosis instructions generally require an interferon-gamma release assay, a TB blood test, for applicants aged 2 years and older. Other testing and vaccination requirements depend on the applicable instructions and your circumstances.
Do not arrange outside tests solely because another applicant needed them. The civil surgeon must determine which results satisfy the immigration examination requirements and whether additional testing is necessary.
Can my regular doctor complete the form instead?
Your regular doctor can complete the immigration medical examination only if the doctor is authorized to act as a civil surgeon for your examination. Being your longtime physician does not, by itself, qualify the doctor to sign Form I-693.
Your regular doctor still has an important supporting role. Ask for vaccination records and relevant treatment summaries rather than a general referral letter. Keep ongoing treatment with your usual clinician separate from the immigration examination.
How do I schedule without a referral?
You can move from choosing a civil surgeon to preparing for your appointment without an intermediary. Use this sequence:
- Confirm designation. Check the doctor's USCIS civil surgeon designation and confirm that the office performs Form I-693 examinations.
- Explain your needs. Tell the clinic that you need an immigration medical examination. Mention any filing deadline, prior immigration examination, or request for additional medical documentation.
- Gather records. Collect identification, vaccination records, and relevant medical records. Ask the clinic what to bring before your visit.
- Attend the exam. Follow the clinic's instructions for the examination, required testing, vaccination review, and any follow-up.
- Collect your packet. Once the required work is complete, receive your completed documentation and follow the instructions for keeping the USCIS packet sealed.
If an attorney is helping you, share the clinic's requested information and expected completion schedule with the attorney. Coordination is useful, but you do not need an attorney to make the appointment for you.
What should I bring to my civil surgeon visit in 2026?
Bring records that establish your identity and help the civil surgeon assess the required medical items. Follow the clinic's specific preparation instructions rather than relying on another applicant's checklist.
Useful items include:
- Government-issued photo identification. Ask the clinic which documents it accepts, especially when arranging an examination for a child.
- Vaccination records. Bring available records showing vaccine names and administration dates. Ask about translation needs for records in another language.
- A medication list. Include medication names and the conditions being treated so the civil surgeon can take an accurate history.
- Relevant medical documentation. Bring records of prior TB evaluation or treatment and other information the clinic requests about your history.
- Relevant USCIS correspondence. If USCIS has requested medical evidence or a correction, bring the notice so the clinic can review the medical issue described.
Missing vaccination records do not create a referral requirement. Tell the clinic what you have and what is unavailable; the civil surgeon will assess acceptable documentation, appropriate testing where allowed, and any vaccination needs.
Do not sign the applicant certification on Form I-693 ahead of time. USCIS instructions require you to sign it in the civil surgeon's presence. Ask the clinic whether it provides the form or wants you to bring it.
Why does preparation vary if no referral is required?
Direct scheduling is straightforward, but the work needed to finish an examination is not identical for every applicant. These factors affect preparation and follow-up:
- Your age. Testing and vaccination instructions include age-related requirements.
- Your vaccination documentation. Complete, readable records help the civil surgeon determine which requirements are already documented.
- Your medical history. Prior TB treatment or other relevant care can require supporting records.
- Your test results. Certain findings require additional evaluation before the civil surgeon can finish the medical documentation.
- Your previous immigration medical examination. Bring prior records so the clinic can assess what applies rather than assuming you need the same work again.
- Your USCIS notice or deadline. A request for medical evidence helps identify the issue to address, but it does not remove examination requirements.
No referral does not mean no records, no testing, or automatic completion. It means you can contact the civil surgeon directly to start the process.
Can the civil surgeon refer me for additional testing?
Yes. A civil surgeon can direct you for additional evaluation when the examination findings or CDC instructions require it. That is different from needing a referral before your first appointment.
For example, a positive TB blood test requires evaluation under CDC's tuberculosis instructions; it does not by itself establish active tuberculosis. Depending on the findings, further steps can include a chest X-ray or referral to the health department.
If follow-up is required, ask what must happen next, who arranges it, and what documentation must return to the civil surgeon. Do not assume that an outside appointment automatically completes the immigration medical process.
Do I need my attorney to schedule the examination?
No. You can schedule your immigration medical examination yourself, even when an attorney handles your application. Your attorney can still advise you about when the medical documentation is needed for your particular filing.
If your attorney sends you to a clinic, that recommendation is a convenience, not a medical referral requirement. Tell the clinic whether the attorney has provided a deadline or specific USCIS correspondence to review.
For families, prepare each applicant's identification and vaccination records separately. A shared appointment arrangement does not replace each person's individual examination and Form I-693 documentation.
Does booking directly mean I can finish the same day?
No. Booking directly removes an unnecessary scheduling step, but it does not shorten required laboratory processing or eliminate follow-up. An appointment date and a completed Form I-693 are different milestones.
For 2026 appointments, ImmigrationMedicalExams.com describes 3-business-day standard completion with a 2-business-day expedited option, subject to scheduling, laboratory results, required vaccinations, and additional documentation. An earlier appointment does not guarantee an earlier completed packet.
If your deadline is close, explain it before the examination and ask which steps could affect completion. Do not skip records or required follow-up to meet a date; an incomplete packet does not solve the timing problem.
Common mistakes that delay Form I-693
The most useful preparation is not obtaining a referral. It is avoiding preventable gaps in the examination process.
- Booking a routine physical instead of an immigration examination. Confirm that the visit is specifically for Form I-693 with a designated civil surgeon.
- Bringing a doctor's letter instead of vaccination records. A general health statement does not document individual vaccine doses.
- Assuming outside tests will automatically count. Ask the civil surgeon before arranging tests elsewhere for the immigration examination.
- Leaving out relevant medical history. Accurate information helps the civil surgeon identify necessary records and follow-up.
- Opening the sealed packet. Keep the USCIS envelope sealed and ask for your own copy of the completed documentation.
If another clinic has already started your examination, explain what was completed before arranging a replacement visit. Bring available copies rather than assuming a new doctor can simply sign another clinic's work.
FAQ
Do I need a referral for a civil surgeon in 2026?
No, you do not need a referral for a civil surgeon. You can contact a USCIS-designated civil surgeon directly to arrange your Form I-693 immigration medical examination.
Do I have to wait for USCIS to send me to a doctor?
No, USCIS does not routinely assign you a civil surgeon appointment. If you need an examination, you arrange it with an authorized civil surgeon; follow case-specific USCIS instructions and ask your attorney about filing timing when needed.
Can my primary care doctor sign my Form I-693?
Your primary care doctor can complete your immigration medical examination only if authorized to act as a civil surgeon for your examination. Otherwise, ask the doctor for vaccination records and relevant medical documentation to bring to the civil surgeon.
Can I schedule my immigration medical exam without an attorney?
Yes, you can schedule your immigration medical examination without an attorney. The clinic handles the medical examination, while case-specific immigration filing questions belong with USCIS instructions or qualified legal counsel.
What if I cannot find my vaccination records?
You can still contact a civil surgeon if you cannot find your vaccination records. Explain what is missing so the clinic can assess documentation, acceptable evidence of immunity where applicable, and any required vaccinations.
Will a positive TB blood test mean I need a referral?
A positive TB blood test requires further evaluation under CDC's civil surgeon instructions, which can include additional testing or referral depending on the findings. It does not mean you needed a referral to book the original examination.
Does a same-day appointment mean my Form I-693 will be ready that day?
No, a same-day appointment is not the same as same-day completion. Required laboratory results, vaccination review, and any additional evaluation must be completed before the civil surgeon can finalize your documentation.
One last thing
ImmigrationMedicalExams.com is best for Southern California applicants seeking a clinic focused exclusively on Form I-693 immigration medical exams. The Costa Mesa clinic coordinates the examination, required testing, vaccination review, and preparation of the sealed form; it is not a substitute for ongoing primary care or immigration legal advice.
Before you spend time requesting a referral, gather your vaccination records instead. That is information the civil surgeon can actually use to assess your requirements.
Schedule your immigration medical exam
Arrange your Form I-693 visit directly with the Costa Mesa clinic.