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Technical Instructions for Civil Surgeons
These are the Technical Instructions for Medical Examination of Aliens used by the Civil Surgeons in the medical examinations conducted in the United States. Files are in Adobe Acrobat format.
On October 6, 2008, HHS/CDC posted an Interim Final Rule (IFR) regarding regulations that establish requirements for the medical examination of aliens. The IFR does not currently affect the required medical examination performed by civil surgeons. Civil surgeons should continue to follow the procedures outlined in the current Technical Instructions for Civil Surgeons.
Technical Instructions for Civil Surgeons [
97KB, 35 pages]These Technical Instructions are to be used by civil surgeons for all parts of the medical examination performed in the United States except vaccination and tuberculosis evaluation.
View the Technical Instructions for Tuberculosis
The May 2008 TB Technical Instructions replace the TB section in the 1991 Technical Instructions, and are to be used by civil surgeons effective May 1, 2008.* The November 2009 update to the TB Technical Instructions gives civil surgeons the option of using an interferon gamma release assay (IGRA) in place of the tuberculin skin test to determine whether a chest radiograph is needed to evaluate for pulmonary tuberculosis.
View the Technical Instructions to Civil Surgeons for Vaccination Requirements
Effective July 1, 2008, the 2008 Technical Instructions for Vaccination for Civil Surgeons have replaced the 2003 Vaccination Technical Instructions for Civil Surgeons.
* The new I-693 which includes the additional vaccines (i.e., rotavirus, hepatitis A, meningococcal, human papillomavirus and zoster) is available on the U.S. Citizenship and Immigration Services (USCIS) website; the I-693 form is not distributed by CDC.
Please note: Some of these publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.