Before Your Appointment
A little preparation before your appointment goes a long way. In the days leading up to your exam, take care of the following:
Gather your passport and photo ID
Your valid, unexpired passport is required for identity verification. Bring a government-issued photo ID (driver's license, state ID, or consular ID) as a secondary document.
Collect all vaccination records from every source
Pull records from your doctor, school, pharmacy, and home country. Even partial or foreign-language records are helpful. Missing records mean more vaccines — and higher cost.
Write down your current medications and medical history
List all current medications with dosages. Note any prior surgeries, hospitalizations, chronic conditions, or mental health treatment. You will be asked about these on the health history questionnaire.
Confirm your appointment time and address
Double-check your appointment details. Our clinic is located at 2900 Bristol St. #C207, Costa Mesa, CA 92626. Plan to arrive 10 minutes early.
Tip: Arriving with complete vaccination records is the single most impactful thing you can do to shorten your appointment and reduce costs.
Step 1 — Check-In & Paperwork
Approximately 10–15 minutes
When you arrive, you will check in at the front desk and present your passport and photo ID. Staff will verify your identity and confirm your USCIS case information if you have a receipt notice (Form I-797).
You will then complete a health history questionnaire covering:
- Your medical history and any chronic conditions
- Current medications and dosages
- Prior surgeries and hospitalizations
- Mental health history and any prior treatment
- Substance use history
Note: Answer the health history questionnaire honestly and completely. The Civil Surgeon uses this information to conduct a thorough and accurate exam.
Step 2 — Physical Examination
Approximately 20–30 minutes
The Civil Surgeon performs a complete head-to-toe physical examination. Each component is documented on Form I-693. The Civil Surgeon is specifically looking for conditions relevant to USCIS inadmissibility grounds — not conducting a routine wellness exam.
Vital Signs
Blood pressure, heart rate, temperature, height, weight, and BMI.
Head, Eyes, Ears, Nose & Throat
Vision screening, hearing assessment, and oral health evaluation.
Cardiovascular
Heart sounds and peripheral pulses assessed for abnormalities.
Respiratory
Lung sounds and breathing assessment for signs of pulmonary disease.
Abdomen
Organ palpation and bowel sounds to assess abdominal health.
Musculoskeletal
Range of motion and gait evaluation.
Skin
Assessment for rashes, lesions, or signs of communicable disease.
Neurological
Reflexes and coordination assessed.
Lymph Nodes
Palpation for enlargement, which may indicate infection or disease.
Reassurance: Most physical exams are unremarkable. The vast majority of applicants have no findings that affect their immigration case.
Step 3 — Vaccination Review
Approximately 10–20 minutes
The Civil Surgeon reviews your vaccination records against the USCIS-required vaccine schedule. Any vaccine not documented in your records must be administered during the appointment. Medical waivers are available for documented contraindications.
USCIS currently requires documentation of vaccines for:
Bring every vaccination record you have — even partial records help. Missing records = more vaccines = higher cost.
Step 4 — Laboratory Testing
5–10 minutes for specimen collection
Required lab tests are ordered for most adult applicants. Specimen collection (blood draw) takes 5–10 minutes. Results are sent to a certified laboratory and reviewed by the Civil Surgeon before Form I-693 is completed.
QuantiFERON-TB Gold (QFT)
Required for most applicantsA blood test for tuberculosis. Replaces the older TB skin test (PPD) for most applicants. Results return in 1–3 business days.
RPR (Rapid Plasma Reagin)
Required — ages 15+A blood test for syphilis. Required for all applicants 15 years of age and older.
Gonorrhea Testing
Required — ages 15+Required for all applicants 15 years of age and older.
Additional Tests
As indicatedAdditional tests may be ordered based on physical exam findings or medical history. The Civil Surgeon will discuss any additional testing with you.
What to expect: A standard blood draw from your arm. Most patients find it mildly uncomfortable and over in under a minute. No fasting is required before your appointment.
Step 5 — Mental Health & Substance Use Screening
Approximately 5–10 minutes
The Civil Surgeon conducts a brief clinical assessment for mental health conditions and substance use disorders that may be relevant to USCIS inadmissibility grounds. This is a medical assessment — not a judgment.
The Civil Surgeon will ask about your history of mental health treatment, hospitalizations, and substance use. They document findings accurately and objectively on Form I-693.
Reassurance: Most mental health histories do not affect immigration cases. The Civil Surgeon's role is to document accurately — not to disqualify applicants.
Step 6 — Civil Surgeon Review & Sign-Off
After all exam components are complete and lab results have returned, the Civil Surgeon reviews the entire Form I-693 for accuracy and completeness. This is the final quality-control step before your form is sealed.
Civil Surgeon reviews Form I-693
Every section is reviewed for accuracy, completeness, and compliance with USCIS Technical Instructions.
Civil Surgeon signs and dates the form
The Civil Surgeon certifies that the exam was conducted in accordance with USCIS Technical Instructions.
Form is placed in an envelope, sealed, and signed across the seal
The sealed envelope protects the integrity of the form. Do not open it — a broken seal may invalidate the form.
You are notified when your sealed Form I-693 is ready
You will receive a notification to pick up or receive your sealed envelope. Timing depends on when lab results are returned.
After Your Appointment
Once your exam is complete, here is what happens next:
Wait for lab results
QuantiFERON-TB Gold and other lab results typically return within 1–3 business days.
Receive notification
We will contact you when your sealed Form I-693 is ready for pickup or mailing.
Pick up or receive your sealed envelope
Do not open the envelope. A broken seal may cause USCIS to reject your Form I-693.
Submit to USCIS
Submit the sealed envelope with your Form I-485, or bring it to your USCIS interview as instructed.
Keep It Sealed
Never open the sealed envelope. USCIS requires the Civil Surgeon's seal to be intact. A broken seal invalidates the form and requires a new exam.
Submit With I-485 or at Interview
Submit the sealed Form I-693 with your I-485 application, or bring it to your USCIS interview. Follow your attorney's guidance on timing.
Valid for 2 Years from Signing Date
Form I-693 is valid for 2 years from the date the Civil Surgeon signs it. Plan your submission timeline accordingly.
Frequently Asked Questions
Related Articles
Medical & Legal Disclaimer: The information on this page is provided for general educational purposes only and does not constitute medical or legal advice. Immigration medical exam requirements, USCIS policies, and vaccine schedules may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to your individual case.