Who Is Required to Complete an Immigration Medical Exam?

The immigration medical examination is a federal requirement for most applicants seeking lawful permanent residence (a green card) in the United States. The exam is mandated by the Immigration and Nationality Act (INA), which requires USCIS to determine whether applicants have any health-related grounds of inadmissibility before approving a green card.

The most common group required to complete the exam is adjustment of status applicants — people already in the United States who are applying to become lawful permanent residents by filing Form I-485.

Adjustment of Status Applicants (Form I-485)

If you are filing Form I-485 to adjust your status to lawful permanent resident while inside the United States, you are almost certainly required to complete an immigration medical examination with a USCIS-designated civil surgeon. The completed and sealed Form I-693 must be submitted to USCIS as part of your application package or brought to your USCIS interview.

• Family-based green card applicants
• Employment-based green card applicants
• Diversity Visa (DV Lottery) adjustment applicants
• Special immigrant category applicants
• VAWA self-petitioners adjusting status

Consular Processing Applicants

If you are applying for an immigrant visa at a U.S. consulate or embassy abroad (consular processing), you will complete a medical examination with a panel physician designated by the U.S. Department of State — not a USCIS civil surgeon. This is a separate process from the Form I-693 civil surgeon exam. If you later adjust status inside the United States, you may need an additional civil surgeon exam.

Refugees, Asylees, and Special Categories

Refugees and asylees who are applying to adjust their status to lawful permanent residence are generally required to complete an immigration medical examination. However, refugees who completed a medical examination abroad prior to admission may have some vaccination requirements waived.

Certain special immigrant categories, including Special Immigrant Juvenile Status (SIJS) applicants and certain religious workers, are also required to complete the exam.

Who Does NOT Need an Immigration Medical Exam?

Not everyone needs an immigration medical exam. Nonimmigrant visa applicants — including tourist visa (B-1/B-2), student visa (F-1), and work visa (H-1B) applicants — are generally not required to complete Form I-693. U.S. citizens do not need an immigration medical exam. If you are unsure whether your specific immigration category requires the exam, consult your immigration attorney.

• Tourist visa (B-1/B-2) applicants
• Student visa (F-1/M-1) applicants
• Temporary work visa (H-1B, L-1, O-1) applicants
• U.S. citizens
• Most nonimmigrant visa categories