The TB Test Reading: A Required Return Visit

The tuberculin skin test (TST) — also called the Mantoux test or PPD test — is placed during your first visit. You must return to the civil surgeon's office 48–72 hours later to have the test read. This return visit is required for all applicants who receive a TST.

The TST reading is a quick visit — the civil surgeon measures the reaction at the injection site and records the result. It typically takes only a few minutes. However, it is a required step before Form I-693 can be completed.

When a Chest X-Ray Is Needed

If your TB test (TST or IGRA) is positive, the civil surgeon will order a chest X-ray to evaluate for active or latent TB. The chest X-ray may be done at the civil surgeon's office or at a radiology facility. You will need to return for the chest X-ray if it is not done on the same day as the TB test reading.

The civil surgeon will review the chest X-ray results before completing Form I-693. If the X-ray shows any findings that require further evaluation, additional follow-up may be needed.

Multi-Dose Vaccine Series

Some required vaccines are administered in multiple doses over several weeks or months. The most common multi-dose series in the immigration medical exam context are: hepatitis B (3 doses over 6 months), HPV (2–3 doses depending on age), and hepatitis A (2 doses over 6 months).

If you need to complete a multi-dose vaccine series, you will need to return to the civil surgeon's office (or another provider) for each dose. Form I-693 cannot be completed until all required vaccines are documented. This can significantly extend the timeline for receiving your completed form.

Deferred Vaccines (Pregnancy)

If you were pregnant at the time of the exam and some vaccines were deferred, you will need to return after delivery to complete the deferred vaccines. The civil surgeon will update Form I-693 to reflect the completed vaccines.

Contact the civil surgeon's office promptly after delivery to schedule the follow-up vaccination appointment. USCIS will not adjudicate your case until all required vaccines are documented.

Additional Evaluation for Unexpected Findings

If the civil surgeon identifies an unexpected finding during the exam — an abnormal laboratory result, a physical finding that requires further evaluation, or a mental health concern — they may refer you for additional evaluation before completing Form I-693.

The civil surgeon will explain any additional evaluation needed and provide referrals as appropriate. Follow up promptly — delays in completing the additional evaluation will delay your Form I-693.

Picking Up Your Completed Form

After all required follow-up visits are complete and all results are available, the civil surgeon will complete Form I-693 and seal it. You will need to return to the office to pick up the sealed envelope. The civil surgeon's office will contact you when the form is ready.