Yes, Newborns Applying for a Green Card Need the Exam

There is no minimum age exemption for the immigration medical examination. If your newborn is in the process of adjusting status to lawful permanent resident — whether through a parent's petition or another qualifying category — USCIS requires a completed Form I-693 (Report of Medical Examination and Vaccination Record) signed by a designated civil surgeon. This requirement applies even to infants who are only days or weeks old. The good news is that the examination is significantly simplified for newborns and very young infants. The civil surgeon understands that many components of the standard adult exam are not applicable to infants, and the process is adapted accordingly. The appointment is typically shorter than for older children or adults, and our staff is experienced in making the experience as comfortable as possible for both baby and parent.

What the Exam Involves for Newborns

For a newborn, the immigration medical examination consists primarily of a physical examination and a review of vaccination records. The civil surgeon will assess the infant's general health, check for any apparent physical conditions that may be relevant to the immigration medical requirements, and review any medical history provided by the parent. There is no chest X-ray required for children under the age of 2. Tuberculosis (TB) screening for very young infants is handled differently than for older children — the civil surgeon will assess the appropriate method based on the infant's age and any known TB exposure history. Blood tests are generally not required for newborns unless there is a specific clinical indication. The physical exam itself is gentle and brief. The civil surgeon will check the infant's weight, length, and general development, and will note any findings relevant to the immigration medical requirements. Parents are encouraged to ask questions at any point during the examination.

Vaccines for Newborns: What Is Age-Appropriate

USCIS requires that applicants receive all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that are age-appropriate and medically appropriate. For newborns, this means only vaccines that are recommended for their specific age will be required. Vaccines that are not yet due on the standard childhood immunization schedule will not be administered. For a newborn, the vaccines most likely to be relevant include the Hepatitis B vaccine, which is recommended at birth. Other vaccines on the standard schedule — such as DTaP, Hib, IPV, and PCV — are typically not due until 2 months of age and will not be required at the newborn exam. The civil surgeon will review your infant's vaccination records and determine which, if any, vaccines are needed at the time of the appointment.

• Hepatitis B (first dose recommended at birth)
• DTaP, Hib, IPV, PCV — not required until 2 months of age
• MMR, Varicella — not required until 12 months of age
• Influenza — not required until 6 months of age
• Only age-appropriate vaccines on the ACIP schedule are required

No Chest X-Ray for Infants

One of the most common concerns parents have is whether their newborn will need a chest X-ray. The answer is no. USCIS guidelines exempt children under the age of 2 from the chest X-ray requirement that is part of the tuberculosis screening process for older applicants. This exemption exists because the radiation exposure from a chest X-ray is not appropriate for very young children, and the clinical utility of the test is limited in this age group. For infants and toddlers under 2 years of age, TB screening is conducted through a review of risk factors and, in some cases, a tuberculin skin test (TST) or IGRA blood test if there is a known exposure history or other risk factors. The civil surgeon will make this determination based on the individual circumstances of your child.

Parent Must Be Present: What to Bring

A parent or legal guardian must be present for the entire immigration medical examination for a newborn. You will be asked to provide informed consent for the examination and any vaccines that are administered. Our staff will explain each step before proceeding and will answer any questions you have. To ensure a smooth appointment, please bring the following items for your newborn:

• The infant's birth certificate or passport
• Any vaccination records from the hospital (e.g., Hepatitis B vaccine given at birth)
• Pediatrician records if available, including any newborn screening results
• Parent or guardian's government-issued photo ID
• Documentation of legal guardianship if the accompanying adult is not a parent
• Any USCIS correspondence related to the adjustment of status application

Scheduling and What to Expect at the Appointment

When scheduling an appointment for a newborn, please let our office know the infant's age so we can allocate appropriate time and ensure the civil surgeon is prepared for an infant examination. Appointments for newborns are typically shorter than for older children, but we recommend arriving a few minutes early to complete any necessary paperwork. Bring everything your baby needs for comfort — a pacifier, a bottle or nursing supplies, a favorite toy or blanket. The examination room is private, and you are welcome to nurse or feed your baby during the appointment if needed. Our staff understands that infants can be unpredictable, and we will work at a pace that is comfortable for your baby. If your infant is unwell on the day of the appointment, please contact us to reschedule — we want to ensure the examination is conducted when your baby is in good health.