The Exam Is a Confidential Medical Encounter

The immigration medical exam is a clinical encounter governed by standard medical privacy rules, including HIPAA. The civil surgeon conducts a physical examination, reviews medical history, and evaluates the applicant for conditions relevant to immigration admissibility. Like any medical appointment, the examination itself is private.

Attorneys are not permitted to be present in the exam room during the physical examination. This is not a USCIS policy — it is standard medical practice. The civil surgeon is the licensed medical professional responsible for the examination, and the clinical encounter is between the civil surgeon and the patient.

What Attorneys Can Do at the Clinic

While attorneys cannot be in the exam room, they can:

• Accompany the client to the clinic and wait in the reception area
• Help the client check in and ensure all required documents are presented
• Speak with clinic staff about scheduling, documentation requirements, or follow-up needs
• Request to speak with the civil surgeon after the examination is complete (subject to the civil surgeon's availability)
• Receive a copy of the medical records with the client's written HIPAA authorization

The Attorney's Most Valuable Role Is Before the Exam

The highest-value work attorneys do in connection with the medical exam happens before the appointment, not during it. Thorough pre-exam preparation significantly reduces the risk of adverse findings, RFEs, and delays.

Before the exam, attorneys should review the client's complete medical history for any conditions that could trigger inadmissibility findings, gather and organize all prior vaccination records (including foreign records), advise the client on what to disclose and how to communicate their history accurately, and confirm that the civil surgeon is currently USCIS-designated.

A well-prepared client who arrives with organized documentation and a clear understanding of the process is far less likely to encounter problems than a client who arrives unprepared.

After the Exam: Attorney Review of Form I-693

After the exam, the civil surgeon will seal Form I-693 in an envelope. The attorney should not open the envelope — doing so breaks the seal and invalidates the form.

However, attorneys can request a copy of the applicant's medical records (with HIPAA authorization) to review the civil surgeon's findings independently. This allows the attorney to anticipate any issues before the USCIS interview and prepare accordingly.

If the civil surgeon identified a Class A or Class B condition, the attorney should receive this information through the client and begin preparing the appropriate response strategy — whether that is a waiver application, treatment documentation, or interview preparation.

Language Access and Interpreter Coordination

If your client has limited English proficiency, coordinate interpreter arrangements before the appointment. Our clinic can accommodate many languages, but advance notice helps ensure the right interpreter is available. Attorneys should not serve as interpreters during the medical examination — this creates a conflict of interest and may compromise the accuracy of the medical history.