Does a Child Born in the United States Need an Immigration Medical Exam?
Quick Answer
No. A child born in the United States is a US citizen by birthright and does not need an immigration medical examination for themselves. The immigration medical exam is required only for individuals who are applying for lawful permanent residence (a green card) or certain other immigration benefits. If a parent is adjusting status, the parent needs the exam — not the US-born child. However, the child may accompany the parent to the appointment.
US-Born Children Are US Citizens
Under the Fourteenth Amendment to the United States Constitution, any person born on US soil is a US citizen at birth. This principle — known as birthright citizenship — means that a child born in the United States does not need to go through the immigration process to establish their right to live and remain in the country. They are already a citizen. Because US citizens are not applying for immigration benefits, they are not subject to the immigration medical examination requirement. The immigration medical exam (Form I-693) is specifically required for individuals applying for lawful permanent residence (a green card) through the adjustment of status process, or for certain other immigration benefits. A US-born child has no need to file Form I-693 and no need to see a civil surgeon for immigration purposes.
The Distinction: Parent Adjusting Status vs. Child
The confusion often arises in families where one or both parents are foreign nationals in the process of adjusting status, but their child was born in the United States. In this situation, the parent who is adjusting status needs the immigration medical examination — the US-born child does not. For example: a mother from another country who entered the US on a visa and is now applying for a green card through her US citizen spouse must complete the immigration medical examination. Her child, who was born in the United States during her time here, is a US citizen and does not need the exam. The mother's I-693 covers only the mother. The child's US citizenship is established by their birth certificate and does not require any immigration medical documentation. This distinction is important because it affects how you schedule appointments and what documents you need to bring. Only the parent (or other family member) who is the actual applicant for immigration benefits needs to be examined by the civil surgeon.
When a US-Born Child Might Be Present at the Clinic
Even though a US-born child does not need the immigration medical examination, they may be present at the clinic for several practical reasons. If a parent is bringing a young child to their own appointment because they have no childcare, the child is welcome to accompany the parent. Our staff is accustomed to families with young children, and we will do our best to make the environment comfortable for everyone. In some cases, a parent may bring a US-born child to the appointment because they are unsure whether the child needs to be examined. If this is your situation, please let our staff know when you arrive. We can quickly clarify whether the child needs to be seen and ensure that only the appropriate family members are scheduled for examinations. There is no need to schedule an appointment for a US-born child — doing so would result in an unnecessary exam and an unnecessary cost.
What If the Child Was Born Abroad to US Citizen Parents?
A child born abroad to US citizen parents may also be a US citizen, depending on the circumstances. Under US law, children born abroad to at least one US citizen parent may acquire US citizenship at birth if certain conditions are met — primarily that the US citizen parent lived in the United States for a required period before the child's birth. If a child acquired US citizenship at birth through a US citizen parent, they are a US citizen and do not need an immigration medical examination. However, establishing this citizenship may require filing Form N-600 (Application for Certificate of Citizenship) or obtaining a US passport. If you are unsure whether your child born abroad is a US citizen, consult with an immigration attorney. Do not assume the child needs an immigration medical exam until you have clarified their citizenship status.
When a Child Born in the US Might Need a Medical Exam for Other Reasons
While a US-born child does not need an immigration medical examination, there are other situations in which a child might need a medical examination for school, travel, or other purposes. These are entirely separate from the immigration medical examination and are not conducted by a civil surgeon under USCIS guidelines. For example, many schools require proof of vaccination for enrollment, and some countries require health certificates for travel. These requirements are handled through the child's regular pediatrician, not through a civil surgeon. If you have questions about what medical documentation your US-born child needs for a specific purpose, consult with their pediatrician or the relevant institution.
Clarifying Your Family's Situation Before Scheduling
If you are unsure which family members need the immigration medical examination, we encourage you to contact our office before scheduling. Our staff can help you understand who needs to be examined based on your family's immigration situation. Scheduling an unnecessary examination for a US-born child wastes time and money and is easily avoided with a quick conversation. When you call, be prepared to explain who in your family is applying for immigration benefits and what type of benefit they are applying for. This will help our staff determine who needs appointments and what documents each person should bring. If you are working with an immigration attorney, they can also advise you on which family members need the civil surgeon examination as part of the adjustment of status process.
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