Applying for U.S. permanent residency is an exciting step—but it comes with many requirements. One of the most essential parts of the immigration process is the USCIS medical exam, a health screening required for many applicants. If you're preparing for this stage, it's important to understand what the exam includes, why it’s necessary, and how to prepare to avoid delays or complications.

What Is the USCIS Medical Exam?

The USCIS medical exam, officially called the Form I-693, Report of Medical Examination and Vaccination Record, is a health evaluation required by U.S. Citizenship and Immigration Services (USCIS) for most individuals applying for a green card or adjusting their immigration status while in the United States.

The purpose of the exam is to ensure that applicants do not have any medical conditions that would make them inadmissible to the U.S. on public health grounds. This includes contagious diseases, lack of required vaccinations, mental or physical disorders associated with harmful behavior, or drug abuse.

Who Needs a USCIS Medical Exam?

You are typically required to take the USCIS medical exam if you are:

• Applying for a green card (lawful permanent residence)
• Filing Form I-485 (Application to Register Permanent Residence or Adjust Status)
• Seeking refugee or asylum status adjustment

This requirement applies to both adults and children and must be completed by a USCIS-designated civil surgeon.

Why Is It Required?

U.S. immigration law requires the government to determine whether an applicant poses a public health risk before allowing them to become a permanent resident. The exam helps screen for:

• Communicable diseases like tuberculosis (TB), syphilis, and gonorrhea
• Missing or incomplete vaccinations as required by U.S. public health guidelines
• Physical or mental disorders with associated harmful behavior
• Substance abuse or addiction

If you do not meet the health standards or fail to provide complete documentation, your green card application could be denied or delayed.

What to Expect During the USCIS Medical Exam

Here’s what you can generally expect when attending your exam:

1. Medical History Review

The doctor will ask about your past medical history, surgeries, hospitalizations, medications, and mental health conditions. Honesty is essential—failing to disclose important information can result in problems with your application.

2. Physical Examination

The civil surgeon will perform a basic physical exam, including:

• Checking your heart, lungs, abdomen, and other vital signs
• Testing your vision and hearing
• Assessing your general health and functionality

3. Tuberculosis (TB) Test

Most applicants will be screened for TB. Individuals aged 2 or older will undergo either a skin test (TST) or a blood test (IGRA). If results are positive, a chest X-ray will be required to rule out active TB.

4. Vaccination Assessment

You must be up-to-date with certain vaccinations required under U.S. immigration law. These include:

• Measles, mumps, and rubella (MMR)
• Polio
• Tetanus and diphtheria
• Varicella (chickenpox)
• Hepatitis B
• Influenza (seasonal)

If you're missing any, the civil surgeon may offer them during the exam or refer you elsewhere.

5. Testing for STDs

Adults between 18 and 44 may be tested for syphilis and gonorrhea, typically via blood and urine tests.

6. Drug and Alcohol Screening

If your history indicates possible substance abuse or mental health disorders, the doctor may evaluate you further and ask for medical records or treatment documentation.

How to Prepare for the USCIS Medical Exam

Preparation can make the process smoother and avoid repeat visits. Here’s what to bring and how to get ready:

✅ Bring the Following Items:

• A valid government-issued photo ID (passport or driver’s license)
• Your vaccination records (translated to English if necessary)
• A list of current medications and dosages
• Any relevant medical history or records
• Your Form I-693 (unless the doctor provides it)

💡 Additional Tips:

• Don’t schedule your exam too early: The I-693 form is only valid for 2 years from the date the doctor signs it.
• Call ahead to confirm pricing and availability—costs vary and may not include lab tests or vaccinations.
• Fast if instructed by the clinic (some require it before blood work).
• Be honest in your responses—attempting to hide medical issues can jeopardize your application.

After the Exam: What Happens Next?

Once your exam is complete:

• The civil surgeon will fill out and sign Form I-693.
• The form is typically sealed in an envelope and handed to you—do not open it, as USCIS will only accept sealed forms.
• Include the sealed I-693 with your green card application (Form I-485), or bring it to your immigration interview if instructed.

If any health concerns are discovered, the civil surgeon will explain your options. Some medical conditions may require treatment or follow-up before your application proceeds. In some cases, a waiver may be available for certain inadmissibility grounds.

Final Thoughts

The USCIS medical exam is a vital step toward your green card or adjustment of status. Though it may seem intimidating, knowing what to expect and preparing ahead of time can ensure a smooth experience.