Does an R-1 Religious Worker Visa Holder Need an Immigration Medical Exam?
Quick Answer
Yes — R-1 religious worker visa holders adjusting status to a green card through Form I-485 must complete an immigration medical exam with a USCIS-designated civil surgeon and submit Form I-693. The exam is the same as for any other adjustment of status applicant.
The R-1 Visa and the Path to a Green Card
The R-1 nonimmigrant visa allows foreign nationals to work in the United States as religious workers for a qualifying religious organization. R-1 holders may serve as ministers, religious professionals, or religious workers in a non-minister capacity. The R-1 visa is typically granted for up to 30 months and can be extended for a total stay of up to five years.
R-1 visa holders who wish to become permanent residents typically pursue the EB-4 Special Immigrant Religious Worker category. This pathway requires the sponsoring religious organization to file Form I-360, Petition for Amerasian, Widow(er), or Special Immigrant, on behalf of the worker. Once the I-360 is approved and a visa number is available, the R-1 holder can file Form I-485 to adjust status to permanent residence.
When the Medical Exam Is Required
The immigration medical exam is not required to obtain or renew an R-1 visa. It is required when you file Form I-485, Application to Register Permanent Residence or Adjust Status. At that point, USCIS requires all applicants to submit Form I-693, Report of Medical Examination and Vaccination Record, completed and signed by a USCIS-designated civil surgeon.
The medical exam requirement applies equally to all I-485 applicants regardless of their current visa category, religious affiliation, or employer. There are no exemptions for religious workers, ministers, or members of religious orders.
What the Immigration Medical Exam Covers
The immigration medical exam covers a complete physical examination, tuberculosis (TB) screening, required laboratory tests, and a vaccination review. The physical exam assesses your general health and screens for conditions that could make you inadmissible on health-related grounds under the Immigration and Nationality Act.
TB screening typically involves a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) blood test. If the initial test is positive, a chest X-ray is required. Required laboratory tests include syphilis serology for applicants age 15 and older and gonorrhea testing for applicants age 15 and older. The civil surgeon will also review your vaccination records and administer any vaccines required by USCIS that you have not already received.
EB-4 Religious Worker Category: Key Requirements
The EB-4 Special Immigrant Religious Worker category is available to ministers and non-minister religious workers who have been a member of a religious denomination with a bona fide nonprofit religious organization in the United States for at least two years immediately preceding the filing of the petition. The sponsoring organization must be a qualifying religious organization under IRS tax-exempt status.
Non-minister religious workers must be working in a religious vocation or occupation. The EB-4 category has a limited number of visas available each fiscal year, and wait times can vary. R-1 holders should consult their immigration attorney about timing the I-360 petition and I-485 filing to minimize gaps in authorized stay.
Timing the Exam Relative to I-485 Filing
Form I-693 is valid for two years from the date the civil surgeon signs it, provided it is submitted to USCIS within that period. Schedule your medical exam 2 to 4 weeks after you receive your I-485 receipt notice. This ensures the I-693 is ready before your USCIS interview and remains valid throughout the processing period.
If your R-1 status is expiring during I-485 processing, consult your immigration attorney about maintaining authorized stay. A pending I-485 generally protects you from removal, but you should not travel outside the United States without advance parole while your I-485 is pending.
What to Bring to Your Appointment
To complete your immigration medical exam, bring your valid passport or government-issued photo ID, your I-485 receipt notice (if available), all vaccination records you have (including records from your home country or religious organization), and any relevant medical records.
Many R-1 visa holders come from countries where vaccination schedules differ from U.S. requirements. Bring all vaccination records you have, even if they are in a foreign language. The civil surgeon can review foreign-language records and may be able to credit vaccines you have already received. Call ImmigrationMedicalExams.com at 714-760-4538 to schedule your exam.
Frequently Asked Questions
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