Medical Examination: Frequently Asked Questions (FAQs)
- What is CDC’s role in medical examinations?
- What is the purpose of the medical examination?
- Who is required to have a medical examination for migration to the United States?
- What does a medical examination entail?
- What are the communicable diseases of public health significance that would cause an applicant to fail a medical examination or be inadmissible?
- What vaccines are required for immigrants overseas and those applying for adjustment of status in the United States?
- Do all vaccine series have to be completed before vaccination requirements are fulfilled?
- Could a person request and be granted a personal-belief waiver from the vaccine requirements?
- How do I become a civil surgeon? What are the requirements for becoming a civil surgeon?
- How do I request a copy of the Technical Instructions for Civil Surgeons?
- What does the blanket designation of health departments as civil surgeons mean?
- How do I make changes to our civil surgeon listing?
- How do I update a patient’s I-693 form if the patient receives an RFE (Request for Evidence) from USCIS because they did not submit their paperwork on time?
- How long are the individual components valid?
- How do I become a panel physician?
- How do I request a copy of the Technical Instructions for Panel Physicians?
- Where does one find detailed instructions for completing the Department of State medical examination forms and associated worksheets for immigrant visa applicants?
- How long is the overseas medical examination of applicants valid?
The Centers for Disease Control and Prevention (CDC) is responsible for providing the technical instructions to civil surgeons and panel physicians who conduct medical examinations for immigration. These instructions are developed to support Immigration and Nationality Act (INA)external icon regulations of health-related grounds for inadmissibility of persons applying for admission into the United States.
The purpose of the medical examination is to identify applicants with inadmissible health-related conditions for the Department of State (DOS) and US Citizenship and Immigration Services (USCIS). Health-related grounds for inadmissibility are infection with a communicable disease of public health significance, failure to present documentation of having received vaccination against vaccine-preventable diseases, a physical or mental disorder with associated harmful behavior, or abuse of drugs (addicts).
|Category||Medical Examination||Provider||Examination Location|
|Status adjusters||Yes||Civil Surgeons||U.S.|
Source: U.S. Department of Homeland Security
* Others include migrants who entered the United States without inspection, including those who entered with and without proper documentation
All immigrants, refugees, and certain nonimmigrants, including fiancés, coming to the United States must have a physical and mental examination prior to coming to the United States by a panel physician. Persons in the United States applying for adjustment of status to a permanent resident of the United States must have a physical and mental examination in the United States by a civil surgeon.
The medical examination procedure consists of a physical examination, an evaluation (blood test/chest x-ray examination) for tuberculosis, urine test for gonorrhea and blood test for syphilis. The vaccination requirements include vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
The technical instructions indicating the required testing, the diseases currently listed as being communicable diseases of public health significance, and the vaccination requirements are available on the CDC website.
Additional immigration information and regulations are available on the USCIS website: http://www.uscis.gov/portal/site/uscisexternal icon
What are the communicable diseases of public health significance that would cause an applicant to fail a medical examination or be inadmissible?
Communicable diseases of public health significance include—
- Hansen’s Disease (Leprosy)
And the following two disease categories–
- Quarantinable diseases designated by any Presidential Executive Order. Current diseases include cholera, diphtheria, infectious tuberculosis, measles, plague, smallpox, yellow fever, viral hemorrhagic fevers (such as Ebola, Lassa, and Marburg), severe acute respiratory syndromes (COVID-19, Middle East respiratory syndrome, SARS), and influenza caused by novel or re-emergent influenza (pandemic flu.)
- Events that are reportable as a public health emergency of international concern (PHEIC) to the World Health Organization (WHO) under the International Health Regulations (IHR) of 2005 (currently COVID-19, polio, smallpox, SARS, pandemic influenza, and other public health emergencies of international concern.)
Some health-related waivers may be available for these diseases. For general information concerning the role that the CDC plays in the waiver process, visit our website. Additional information concerning Form I-601, the waiver application, and the requirements is located on the US Citizenship and Immigration Services (USCIS) websiteexternal icon and Form I-601, Application for Waiver of Grounds of Inadmissibilityexternal icon.
What vaccines are required for immigrants and those applying for adjustment of status in the United States?
As part of the medical examination for immigration, all immigrants, depending on their age, are required to be vaccinated against the following vaccine-preventable diseases: COVID-19, mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, Haemophilus influenzae type B, rotavirus, hepatitis A, hepatitis B, meningococcal disease, varicella, influenza, and pneumococcal pneumonia. Persons already in the United States applying for adjustment of status for permanent residency, including refugees, are also required to be vaccinated against these vaccine-preventable diseases.
The Technical Instructions for Panel Physicians have an addendum regarding polio vaccination requirements for immigrants.
For vaccines requiring a series, only a single dose is required for immigration purposes, except for the COVID-19 vaccine series. For most vaccines, if administration of the single dose of a vaccine at the time of the medical examination does not complete the series for that vaccine, the “Insufficient time interval to complete series” reason should be documented to indicate that additional doses will be needed to complete the series for that vaccine. The applicant should also be counseled to complete the series in the future. For COVID-19, applicants are required to complete the primary vaccine series (1 or 2 doses depending on the vaccine) before the medical examination can be considered complete.
The applicant needs to check with USCIS to obtain the application for a waiver based on religious or moral conviction. It is a separate application process to obtain an individual waiver based on religious or moral conviction.
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 Doctorexternal icon
Form I-693 Report of Medical Examination and Vaccination Recordexternal icon is available on the USCIS website.
How do I request the Department of State (DOS) medical examination forms and associated worksheets for immigrant visa applications?
The Department of State (DOS) forms for medical examination of immigrant visa applicants (DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026) are not available on the CDC website.
Since the forms are DOS forms, information about obtaining these forms may be requested on DOS website: https://travel.state.gov/content/travel/en.htmlexternal icon
Prospective civil surgeons must apply for civil surgeon designation using Form I-910, Application for Civil Surgeon Designationexternal icon with US Citizenship and Immigration Services (USCIS), must have at least 4 years of professional experience, not including time spent in residency or training, an unrestricted license to practice medicine in the state in which they are conducting the immigration medical examinations, and be authorized to work in the United States.
CDC is responsible for providing the technical instructions to civil surgeons conducting medical examinations for immigration. The instructions, along with important updates, are available on our website.
The instructions, along with important updates, are available on the CDC website.
General information concerning civil surgeons and the medical examination required for immigration purposes is also available on the USCIS websiteexternal icon.
The blanket designation of health departments as civil surgeons applies only to physicians conducting the vaccination assessment for refugees adjusting status. Also, only health departments that have a physician or physicians meeting the requirements for civil surgeon designation can participate in this designation, and accepting the designation is entirely voluntary on the part of health departments.
The Technical Instructions for Civil Surgeons, in their entirety, are available on CDC’s website.
The vaccination section of the technical instructions includes information on the blanket designation of health departments as civil surgeons for the vaccination assessment of refugees, as well as the instructions for completing the vaccination assessment for refugees.
USCIS policy also allows for blanket designation for military physicians to complete all parts of the immigration medical examination for service members, veterans, and their eligible dependents at military treatment facilities. For more information on blanket designations, visit the USCIS Policy Manualexternal icon.
You must contact the USCIS concerning request for changes to the civil surgeon listing including address, phone number, and addition of physicians in your office. To locate the nearest USCIS office for your area, visit the USCIS website: http://www.uscis.gov/portal/site/uscisexternal icon
How do I update a patient’s I-693 form if the patient receives an RFE (Request for Evidence) from USCIS because they did not submit their paperwork on time?
For USCIS policies regarding the validity of Form I-693, see the USCIS Policy Manualexternal icon:
For the I-693 Medical Examination, the civil surgeon will complete all components. This includes the physical examination, all required testing, as well as the next dose of any age-appropriate required vaccines. Order and complete all tests, including the chest x-ray, at the time of the I-693 medical examination and report those results on the I-693 medical examination form. Further, laboratory testing should only be performed at the civil surgeon’s designated laboratory. Outside chest x-rays and laboratory testing are not accepted for the purposes of this exam. The examination should reflect the applicant’s current state of health and should be performed with safeguards to prevent fraud.
The completed I-693 medical examination form must contain the official stamp or seal of office and be given to the refugee in a sealed envelope for presentation to the U.S. Citizenship and Immigration Services (USCIS). The form must also be signed by a health department physician who has at least 4 years of professional experience.
All components of the I-693 exam completed by a civil surgeon are valid for 1 year; if the results are over a year old, they will need to be repeated by the civil surgeon.
Exceptions include applicants with written documentation from a physician of a previous positive IGRA and COVID-19 vaccination. For past positive IGRA results, the written documentation must include date of the test, type of IGRA performed, test results in standard units of measurement, the test interpretation (e.g., positive, negative, indeterminate, borderline), and the testing physician’s name, signature, and office information. Applicants should be advised to receive the COVID-19 vaccine as soon as possible from any location that is convenient to them and bring documentation to the civil surgeon. They do not need to wait for the civil surgeon appointment to complete this vaccination series.
The Centers for Disease Control and Prevention (CDC) is responsible for providing the technical instructions to panel physicians conducting medical examinations for immigration.
The instructions, along with important updates, are available on our website.
Where does one find detailed instructions for completing the Department of State medical examination forms and associated worksheets for immigrant visa applicants?
The Department of State (DOS) forms for medical examination of immigrant visa applicants, (DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026) are not available on the CDC website.
Since DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026 are DOS forms, information about obtaining these forms should be requested on the DOS website: https://travel.state.gov/content/travel/en.htmlexternal icon.
Most medical examinations are valid for 6 months. However, examinations with certain TB classifications as defined in the Tuberculosis Technical Instructions (TB TIs) for panel physicians are only valid for three months.
Medical examinations are valid for 6 months for individuals with the following classifications:
- No Class (i.e., No Apparent Defect, Disease, or Disability)
- Class A Other than TB with Waiver
- Class B2, Latent TB Infection (LTBI) Evaluation
- Class B3 TB, Contact Evaluation
- Class B, all except TB, including specific Class B conditions
- Class B Other conditions
Medical examinations are valid for 3 months for individuals with the following classifications:
- Class A TB with Waiver
- Class B1 TB, Pulmonary*
- Class B1 TB, Extrapulmonary*
- Class B0 TB, Pulmonary*
*Travel clearance is valid for 3 months from the date final cultures are reported as negative.
Panel physicians are selected by US Department of State (DOS) embassies and consulates. Therefore, you should contact the appropriate American Embassy or Consulate for information on how to become a panel physician. Contact information for those offices is available at the Official list of embassies from the U.S. Department of State (usembassy.gov)external icon
CDC is responsible for providing the technical instructions to panel physicians conducting medical examinations for immigration. Those instructions, in their entirety, are available on our website.