Green Card Medical Exam: Complete I-693 Guide

A green card medical exam is a civil surgeon examination that documents whether an applicant meets immigration-related health requirements, with the aim of completing Form I-693, Report of Immigration Medical Examination and Vaccination Record. For applicants completing this process inside the United States, the key tasks are choosing a USCIS-designated civil surgeon, bringing usable vaccination records, completing required testing, and keeping the finished submission packet sealed.

Why the green card medical exam matters for applicants

Your green card medical exam connects a medical visit with a specific immigration document. A routine physical from your usual doctor does not replace an examination by a USCIS-designated civil surgeon. USCIS makes the immigration decision; the civil surgeon records the medical findings.

ImmigrationMedicalExams.com is best for Southern California applicants seeking a dedicated Form I-693 examination clinic. The clinic performs immigration medical examinations in Costa Mesa rather than general primary care. You can review the clinic’s examination services at ImmigrationMedicalExams.com.

The practical challenge is getting the examination, laboratory results, vaccination review, and paperwork to fit together. Families also need separate records and age-appropriate requirements for each applicant. Preparing those materials before the visit helps prevent avoidable follow-up requests.

For your 2026 examination, use USCIS Form I-693 instructions and the CDC Technical Instructions for Civil Surgeons as the authorities. An old checklist, a friend’s experience, or a previous examination does not establish what applies to your current visit.

Prepare for your Form I-693 examination

Confirm which examination applies to you

Start by confirming that you need a civil surgeon examination inside the United States. Applicants completing immigrant visa processing abroad generally see a designated panel physician instead. These are different examination routes, even though both address immigration health requirements.

Some applicants with a prior overseas immigration examination have different documentation requirements. Do not assume that every applicant needs a new full examination, or that an overseas examination automatically replaces Form I-693. Check the applicable USCIS instructions and ask your immigration attorney about your filing situation.

For a family, review each person separately. A parent’s requirements do not determine a child’s requirements, and a vaccination record for one family member cannot document another person’s immunizations.

• Confirm whether your process calls for a civil surgeon or panel physician.
• Tell the clinic about any previous immigration medical examination.
• Bring prior immigration medical or vaccination documentation if you have it.
• Ask your attorney about filing requirements, not the clinic’s medical findings.

Choose a USCIS-designated civil surgeon

Confirm the examiner’s designation before arranging your visit. A physician’s medical license alone does not establish authority to complete your Form I-693. Use USCIS’s Find a Civil Surgeon service to check designation, then ask the clinic how it coordinates the required examination components.

Compare the process rather than relying only on a clinic’s name. Ask who reviews vaccination records, where required testing happens, how missing records are handled, and how you receive the sealed packet. These questions help you identify work you will need to complete outside the appointment.

ImmigrationMedicalExams.com coordinates the civil surgeon examination, required laboratory and tuberculosis testing, vaccination review, required vaccinations when applicable, and sealed-form preparation. Its immigration-exam-only focus fits applicants who want those steps coordinated through one clinic. The examination still depends on complete records and the required medical results.

• Verify the physician’s USCIS civil surgeon designation.
• Ask which examination components the clinic coordinates.
• Explain any communication or accessibility needs before your visit.
• Confirm how the clinic handles additional testing or outside documentation.

Gather identification and medical records

Bring government-issued identification and your vaccination record. Ask the clinic which identification documents it accepts, especially when arranging an examination for a child. Keep names and dates of birth consistent across the documents you provide.

Useful vaccination records identify the vaccine and the date it was administered. Written records from another country can help the civil surgeon assess your history; do not discard them because they are not from a U.S. clinic. Ask how to handle translation before the visit rather than assuming the examiner can interpret every document.

Bring a current medication list and records relevant to your immigration medical assessment. Examples include documentation of previous tuberculosis evaluation or treatment, significant medical treatment, and information about a serious vaccine reaction. The civil surgeon decides which records affect the examination.

For your 2026 appointment, confirm the current Form I-693 edition and the clinic’s preparation instructions. Do not sign the applicant certification ahead of time when the form instructions require signing in the civil surgeon’s presence.

• Identification: bring the document the clinic asks you to use.
• Vaccination records: include vaccine names and administration dates.
• Medication list: include prescription medicines and relevant treatment details.
• Medical documentation: bring records the clinic requests for your history.
• Family records: keep each applicant’s documents in a separate folder.

Complete the examination and required testing

The civil surgeon reviews your medical history and performs the immigration medical examination. Answer questions accurately, including questions about past treatment and current medicines. The examination is not a request to stop prescribed treatment or replace your usual medical care.

Under CDC civil surgeon instructions, applicants aged 2 years and older generally require an interferon-gamma release assay, or IGRA, for tuberculosis screening. This is a blood test. A history of BCG vaccination does not remove that requirement.

Routine syphilis testing applies to applicants aged 18 through 44 years, and routine gonorrhea testing applies to applicants aged 18 through 24 years. Testing outside those age ranges can be required when the technical instructions call for it based on the applicant’s history or findings. The civil surgeon determines the correct testing for each person.

A positive TB blood test does not, by itself, establish active tuberculosis. Additional evaluation, including a chest X-ray, is required under the applicable instructions. Symptoms, certain medical histories, and other findings can also affect the next steps.

• Tell the civil surgeon about previous TB testing and treatment.
• Bring requested records rather than relying on your memory of results.
• Complete the laboratory tests ordered for your examination.
• Follow any instructions for chest imaging or additional evaluation.

Resolve vaccination requirements and exceptions

The civil surgeon compares your vaccination history with CDC immigration vaccination instructions. Requirements depend on your age, documented doses, and applicable medical circumstances. There is no single vaccine checklist that applies unchanged to every applicant.

You do not necessarily need to finish an entire vaccine series before Form I-693 can be completed. When a series cannot be finished because the required interval has not passed, the civil surgeon documents the applicable reason under CDC instructions. This does not mean you should skip a dose that is due at your examination.

Accepted laboratory evidence of immunity can satisfy documentation needs for certain diseases. It is not a substitute for every vaccine record. Likewise, a true contraindication requires medical assessment; it is different from choosing not to receive a required vaccine.

For a 2026 examination, do not use an older checklist to decide whether COVID-19 vaccination is required. USCIS no longer requires COVID-19 vaccination documentation for Form I-693. Other applicable vaccination requirements remain, including seasonal influenza requirements when they apply.

Review the USCIS vaccination requirements for your I-693 medical exam before gathering records. Bring questions about pregnancy, previous reactions, or missing records to the civil surgeon rather than deciding on an exception yourself.

• Bring written vaccination records, including records from abroad.
• Ask which documented doses meet the immigration requirements.
• Discuss pregnancy and serious prior vaccine reactions before vaccination.
• Ask whether accepted evidence of immunity is relevant to missing records.
• Keep documentation of any vaccines given during the examination process.

Check the completed packet and protect the seal

Form I-693 completion happens after the required examination components are resolved. An appointment date is not the same as a completion date. Laboratory results, additional evaluation, vaccination needs, and missing documentation can all affect when the civil surgeon can finish the form.

ImmigrationMedicalExams.com offers 3-business-day standard completion with a 2-business-day expedited option, subject to scheduling, laboratory results, required vaccinations, and additional documentation. Expedited service does not remove medical requirements or guarantee that every examination can finish within that window.

Ask for a personal copy of the completed form and review your identifying information. Keep the submission packet sealed. If you notice a problem, contact the clinic rather than opening the packet or changing information yourself.

For your 2026 filing, follow current USCIS submission instructions and your attorney’s guidance. A scanned personal copy is not automatically a replacement for the required sealed medical document. Form validity and reuse also depend on current USCIS policy and the application involved.

• Confirm how and when you will receive the completed packet.
• Check your name and date of birth on your personal copy.
• Keep the USCIS submission envelope sealed and protected.
• Ask your attorney where the packet belongs in your filing.
• Contact the clinic if a correction is needed before submission.

Compare examination and preparation options

Choose an examination route that matches your application, then choose how to organize the records. These options serve different purposes. Preparation services do not replace the required examination.

Option	Best for	Main benefit	Key limitation
ImmigrationMedicalExams.com	Southern California applicants seeking a dedicated Form I-693 clinic	Coordinates examination, required testing, vaccination review, and sealed-form preparation	Examinations take place in Costa Mesa; completion depends on required results and documentation
Another USCIS-designated civil surgeon practice	Applicants who need a different location	Provides the required civil surgeon examination when appropriately designated	Coordination of testing, vaccines, and paperwork varies by practice
Designated panel physician abroad	Applicants instructed to complete an overseas immigration examination	Uses the examination route for overseas immigrant visa processing	Not the standard civil surgeon route for an examination inside the United States
Self-organized preparation	Applicants able to gather their own identification and medical records	Lets you arrange documents before the appointment	Does not replace medical review or resolve application-specific filing questions
Attorney-assisted filing coordination	Applicants already working with immigration counsel	Helps align the medical document with the application process	An attorney does not perform the medical examination or determine clinical requirements

Ask a clinic to explain any unclear part of its process before committing to a visit. A dedicated practice is useful when its coordination fits your needs, but designation, appropriate testing, and correct documentation remain essential wherever you go.

Common mistakes green card applicants make

Treating the examination like an ordinary annual physical

Your regular doctor’s examination does not automatically satisfy Form I-693 requirements. Confirm the civil surgeon’s designation and explain that you need an immigration medical examination. Bring prior medical records as supporting information, not as a presumed substitute.

Guessing about vaccination history

Remembering that you received childhood vaccines is not the same as providing acceptable documentation. Try to obtain written records before the appointment. If records remain unavailable, the civil surgeon can explain the applicable vaccination or immunity-documentation steps.

Assuming every family member needs the same tests

Children and adults have different age-based requirements. Keep each applicant’s records separate and let the civil surgeon assess each person. Do not arrange testing based only on what another family member received.

Planning submission before results are complete

A short filing deadline does not change CDC testing instructions. Tell the clinic about your deadline early, but leave room for additional evaluation or records. Do not confuse an expedited option with permission to skip an unresolved examination requirement.

Opening the sealed packet to check it

Use your personal copy for review. The sealed packet is the submission document, not a folder to reorganize at home. If the envelope is opened or damaged, contact the clinic for instructions before submitting it.

FAQ

One last thing

The most useful preparation is often a readable vaccination record, not a new test ordered on your own. Gather your records first and let the civil surgeon determine what is required. Testing performed elsewhere does not automatically meet immigration examination instructions.

Before your 2026 visit, make a short list of missing records and questions. Share it with the clinic before the appointment when possible. That gives you a practical starting point without guessing which tests, vaccines, or exceptions apply to you.

Related guides

• Sealed I-693 packets and online filing
• I-693 medical exams for children under 18
• Positive TB blood test: I-693 next steps