Each Person's Exam Stands on Its Own

One of the most important things to understand about immigration medical exams is that they are entirely individual. Even when a family comes in together on the same day, each applicant is evaluated separately, receives their own physical examination, has their own vaccination records reviewed, and leaves with their own sealed Form I-693 or equivalent documentation. There is no combined or joint exam — the process is person-by-person, regardless of family relationships.

This means that having family members with different immigration statuses does not create a conflict or a problem. The civil surgeon simply evaluates each person according to the requirements that apply to their specific immigration pathway. One family member applying for adjustment of status (Form I-485) will follow the USCIS Form I-693 process, while another family member going through consular processing at a US embassy abroad will follow the DS-5540 process. These are parallel, independent tracks that can proceed simultaneously.

The practical implication for families is that you do not need to wait for everyone to be on the same immigration track before scheduling exams. If your family is ready — even if different members are at different stages of their immigration journey — you can schedule a same-day appointment and each person will be handled appropriately for their situation.

US Citizens in the Family Do Not Need an Exam

If one or more family members are already US citizens, they do not need an immigration medical exam. The immigration medical exam is required only for individuals who are applying for an immigration benefit — such as a green card through adjustment of status or an immigrant visa through consular processing. US citizens are not applicants in this context, so there is nothing for them to complete.

This is a common situation in mixed-status families. For example, a US citizen parent may be sponsoring a spouse and children who are applying for green cards. The US citizen parent has no exam requirement; only the spouse and children who are the actual applicants need to be seen by the civil surgeon. Similarly, if a child was born in the United States and is therefore a US citizen, that child does not need an immigration medical exam even if their siblings do.

If you are unsure whether a family member needs an exam, the safest approach is to confirm with your immigration attorney or to call our office. Bringing a family member who does not need an exam is not harmful, but it is unnecessary. We can help you identify who in your family actually has an exam requirement before you schedule your appointment.

• US citizens are not required to complete an immigration medical exam
• Only applicants for green cards or immigrant visas need to be seen
• A US citizen parent sponsoring family members does not need an exam
• US citizen children born in the US are exempt, even if siblings are not
• Call our office if you are unsure who in your family needs an exam

Adjustment of Status vs. Consular Processing: Key Differences

The two most common immigration pathways for family members are adjustment of status (applying for a green card while already in the United States) and consular processing (applying for an immigrant visa at a US embassy or consulate abroad). These pathways use different forms and have different procedural requirements, which affects how the immigration medical exam is handled.

For adjustment of status, the medical exam is completed on Form I-693, which is sealed by the civil surgeon and submitted to USCIS either with the I-485 application or at a later stage. The civil surgeon must be USCIS-designated, and the exam must be completed within a specific validity window. Our office handles I-693 exams for adjustment of status applicants.

For consular processing, the medical exam is completed on Form DS-5540 and is typically arranged through the National Visa Center or the US embassy in the applicant's home country. This exam is usually performed by a panel physician designated by the embassy, not by a USCIS civil surgeon in the United States. If some family members are in the US pursuing adjustment of status while others are abroad pursuing consular processing, each group will follow their respective pathway independently.

• Adjustment of status uses Form I-693, completed by a USCIS civil surgeon in the US
• Consular processing uses Form DS-5540, completed by an embassy panel physician abroad
• Family members on different pathways follow their respective processes independently
• Our office handles I-693 exams for adjustment of status applicants
• Consular processing exams are arranged through the US embassy in the applicant's country

Different Visa Categories and Their Exam Requirements

Beyond the adjustment of status vs. consular processing distinction, different visa categories can affect the specifics of what is required at the medical exam. For example, K-1 fiancé visa applicants complete a medical exam as part of the K-1 process, and then must complete a second exam after entering the US and filing for adjustment of status. If a family member is on a K-1 visa and others are on different pathways, the K-1 applicant may be at a different stage of their medical exam process.

Refugee and asylee applicants have their own medical exam requirements, which may differ from standard green card applicants. Certain refugee applicants may have had overseas medical exams completed before arrival in the United States, and these may satisfy some or all of the domestic exam requirements. If a family member has refugee or asylee status, it is important to discuss their specific situation with our office before scheduling.

Derivative beneficiaries — family members who are included in a primary applicant's petition — generally follow the same exam process as the primary applicant, but each person still completes their own individual exam. The fact that a child is a derivative beneficiary on a parent's petition does not change the requirement that the child receive their own age-appropriate evaluation and their own Form I-693.

What Each Person Needs to Bring

Because each family member's exam is independent, each person needs to bring their own complete set of documents. This is true even if family members are being seen on the same day. Do not assume that one family member's documents can cover another person — USCIS requires individual documentation for each applicant.

Each applicant should bring: a valid government-issued photo ID (passport is preferred), their complete vaccination records (including any records from other countries), any prior immigration medical exam results if applicable, and their USCIS receipt notice or case number if available. Children should have their vaccination records brought by a parent or legal guardian, who must also be present during the exam.

If different family members have different immigration statuses, it may also be helpful to bring documentation of each person's current status — such as a copy of their visa, their I-94 arrival record, or their pending I-485 receipt notice. This helps our civil surgeon understand the context of each person's exam and ensure the correct form and process is used for each applicant.

• Each applicant must bring their own photo ID (passport preferred)
• Each person needs their own complete vaccination records
• Bring USCIS receipt notices or case numbers if available
• Children's records must be brought by a parent or legal guardian
• Documentation of current immigration status is helpful for each person
• Do not assume one person's documents can be shared with another family member

How to Coordinate a Mixed-Status Family Appointment

Scheduling a same-day appointment for a mixed-status family is straightforward at our office. When you call to schedule, simply let us know how many family members will be coming, their approximate ages, and — to the extent you know — what immigration pathway each person is on. This allows us to allocate the right amount of time and ensure we have the correct forms and processes ready for each person.

If you are unsure about the details of each family member's immigration status or pathway, that is okay. Our civil surgeon will review each person's situation at the appointment and determine the appropriate process. However, the more information you can provide in advance, the smoother the appointment will go. If any family member has a complex situation — such as a prior immigration medical exam, a history of a communicable disease, or a pending waiver — it is especially helpful to mention this when scheduling.

Mixed-status families sometimes worry that having some members with more complex immigration histories will slow down the exams for others. In practice, each person's exam proceeds independently, so a complication for one family member does not delay the others. Everyone who is ready can complete their exam on the same day, and any family member who needs additional follow-up can return separately without affecting the rest of the family.