Technical Instructions for Civil Surgeons

At a glance

The Centers for Disease Control and Prevention (CDC), United States Public Health Service (PHS), is responsible for ensuring that noncitizens entering the United States do not pose a threat to the public health of this country. The medical examination required by CDC regulations is a means of evaluating the health of persons applying for entry into the United States.

Doctor examining patient

Medical Examination

Applicants must undergo a physical and mental examination as part of the application process. The purpose of the medical examination is to identify the presence or absence of certain disorders that could result in exclusion from the United States under the provisions of the Immigration and Nationality Act.

Civil Surgeons

Civil surgeons must follow specific identification procedures, prescribed by the U.S. Department of Homeland Security (DHS), to ensure that the person appearing for the medical examination is the person who is actually applying. The civil surgeon is responsible for the entire examination, including chest radiographs, when required, and necessary laboratory procedures. The civil surgeon is also responsible for reporting the results of all the required tests and consultations on the prescribed forms. The civil surgeon is not responsible for determining whether an applicant is actually eligible to adjust their status; that determination is made by the DHS officer after reviewing all records, including the report of the medical examination.

A list of civil surgeons (doctors in the United States who perform medical examinations for persons adjusting their status to permanent residency) is available at USCIS – Find a Doctor.

I-693 Form‎

U.S. Citizenship and Immigration Services (USCIS) distributes the I-693 Form, Report of Immigration Medical Examination and Vaccination Record.

Technical Instructions

These instructions are in accordance with CDC regulations and are for the use of civil surgeons evaluating persons applying for adjustment of status to permanent resident and others required by law to have a medical examination.

For any questions about these Technical Instructions, civil surgeons should contact the Immigrant and Refugee Health Branch of the Division of Global Migration Health (DGMH), Centers for Disease Control and Prevention (CDC), at Inquiries from the general public should be sent to CDC-INFO.

HIV Guidance‎

On November 2, 2009, the Department of Health and Human Services published a final rule regarding HIV infection. In this final rule, HIV infection was removed from the list of inadmissible conditions for immigration purposes and from the scope of the immigrant medical examination. The rule went into effect on January 4, 2010 after which HIV testing was no longer required as part of the U.S. immigration medical screening process and persons with HIV infection will no longer require waiver processing by the Department of Homeland Security to be admitted into the United States. These changes for HIV do not affect the Technical Instructions for other inadmissible conditions, such as tuberculosis.