Preparing for Your
Medical Exam

Health-Related Grounds of Inadmissibility

There are several health-related reasons that could result in a denial of your green card application. Below are the primary categories the civil surgeon will evaluate during your medical exam.

Communicable Diseases

If you have certain communicable diseases that are considered a public health risk, you may be denied a green card. These diseases include:

• Active, untreated tuberculosis (TB)
• Gonorrhea
• Leprosy (infectious form)
• Syphilis

If you are diagnosed with any of these conditions, you will be required to undergo treatment and be declared non-infectious before continuing with your application process. Your application will be put on hold until the disease is successfully treated and you provide medical documentation confirming recovery.

Drug and Alcohol Abuse

A history of drug or alcohol abuse or current substance abuse could also lead to a denial of your green card application. The civil surgeon will assess your drug and alcohol use history during the exam. Below is what could impact your eligibility:

• If you have a history of drug abuse, you may be asked to take a drug test or provide proof that you have completed a drug treatment program.
• If you are currently abusing prescription drugs, illegal drugs, or alcohol, you will not be allowed to get a green card until you can demonstrate that you have ceased the abuse.
• If your alcohol abuse has led to repeated incidents of dangerous behavior, such as drunk driving, this may be considered a risk factor under mental health considerations.

Mental Illness with a History or Threat of Violence

If you have a mental illness that has caused violent behavior in the past or is associated with a risk of future violence—whether directed at yourself or others—it may impact your eligibility for a green card. Examples include:

• Self-harm or suicidal behavior
• Violent acts against others, which could include incidents of domestic violence or assault
• Drunk driving, especially if it demonstrates reckless behavior that could endanger public safety

If the civil surgeon determines that your mental health condition poses a potential danger, it may lead to denial until further treatment is sought and risk factors are mitigated.

Inability to Work (Public Charge Consideration)

If your health is so poor that you are unable to work and support yourself financially, this may be considered under the "public charge" rule, which assesses whether you are likely to become dependent on government benefits. People with serious degenerative or fatal diseases may be denied on the grounds that they would not be able to financially support themselves and might rely on public assistance.

Applicants with such health conditions may need to provide evidence that they will not become a public charge, such as showing sufficient financial support from family members or sponsors or proving access to adequate healthcare.

Schedule the Medical Exam

You must have your medical exam conducted by a civil surgeon authorized by U.S. Citizenship and Immigration Services (USCIS). You can find a qualified civil surgeon near you by visiting the USCIS Civil Surgeon Locator.

What to Bring to Your Exam

Make sure you bring the following items to your medical exam appointment:

• Government-Issued Photo ID: Bring a valid passport, driver's license, or another form of identification.
• Form I-693: Bring a copy of the Form I-693 for the civil surgeon to complete. It is important that you bring the most recent form edition date, which you can ensure by printing the latest version from the USCIS website. Do not sign the form until instructed by the civil surgeon to do so.
• Immunization/Vaccination Records: Gather your vaccination records (from your home country, previous medical providers, etc.) to show the civil surgeon. If you are missing any required vaccines, the civil surgeon may administer them during your exam.
• Medical History: If you have a history of serious illness, surgery, or any medical condition, bring relevant medical documentation to your appointment.
• List of Medications: Be prepared to provide the civil surgeon with a list of all medications you are currently taking.

Required Vaccinations

Below is the list of vaccines that applicants may be required to receive based on age and health status:

• Diphtheria
• Tetanus
• Pertussis
• Polio
• Measles
• Mumps
• Rubella
• Rotavirus (for infants aged 6 weeks to 8 months)
• Haemophilus influenzae type b (Hib) (for children under 5 years old)
• Hepatitis A
• Hepatitis B
• Meningococcal disease (for adolescents and young adults)
• Varicella (Chickenpox)
• Pneumococcal disease (for children under 5 and adults over 65)
• Influenza (flu) (required annually for applicants 6 months and older during flu season)

The civil surgeon will assess which vaccines are age-appropriate and necessary for your particular case. If you have already received some or all of these vaccines, please provide proof of vaccination. If you have not received one or more of these required vaccines, the civil surgeon will administer the necessary doses during your medical exam.

Laboratory Testing for Immunity

In some cases, instead of receiving additional vaccinations, you may be able to show proof of immunity to certain diseases through laboratory testing. The civil surgeon may recommend this option based on your vaccination history or medical records. If the tests confirm immunity, you will not need to receive further vaccinations for those specific diseases.

Below is a list of diseases that can be confirmed via blood testing:

• Measles
• Mumps
• Rubella
• Hepatitis A
• Hepatitis B
• Polio (all three poliovirus types)
• Varicella (Chickenpox)

If the blood tests show sufficient immunity, no additional vaccinations for those diseases will be required. However, if immunity is not confirmed or there is no valid vaccination record, the civil surgeon will recommend the necessary vaccines.

Medical Exam Components

The I-693 medical exam includes several key components:

• Physical Examination: The civil surgeon will conduct a general physical exam, including a review of your overall health.
• Tuberculosis (TB) Testing: USCIS requires a TB blood test (interferon-gamma release assay, IGRA) for individuals aged 2 and older.
• Mental Health Screening: You may be asked about your mental health, including any history of substance abuse or psychiatric treatment.
• Review of Vaccination Records: The civil surgeon will verify that you have received the necessary vaccinations.

Cost of the Medical Exam

The cost of the I-693 medical exam can vary depending on the civil surgeon and location. This cost typically includes the exam itself, required vaccinations, and any necessary lab tests, such as TB screening.

Generally, the cost of the I-693 medical exam is not covered by health insurance, as it is considered part of the immigration process and not a routine medical procedure. However, if you need additional vaccines or tests that are part of standard healthcare, certain health insurance plans may cover those specific elements. We recommend contacting your health insurance provider in advance to confirm what, if any, portions of the exam or required vaccinations may be covered.

Validity of Medical Exams

Receiving the Completed Form I-693

Once the examination is complete and you meet all the medical and vaccination requirements, the civil surgeon will provide you with a sealed envelope containing your completed Form I-693. Do not open the envelope. This sealed envelope will be submitted to USCIS along with your green card application.

Important Tips

• Follow any instructions the civil surgeon gives you regarding further testing or vaccines.
• The sealed envelope is essential—opening it will invalidate the form, and you will be required to redo the exam.
• While the original form itself must remain sealed, ask the civil surgeon for a copy of the completed I-693 for your records.

Sending Your Results to Our Office

Please send the sealed medical exam results to our office at:

Immigration policies and regulations are complex and frequently subject to change. The information contained in this guide is intended to provide you with a general overview and may not address your particular circumstances and needs. Serotte Law will assist you in navigating the complexities of the I-693 Medical Exam and answer any questions you may have. Request a consultation or give us a call at 888-875-8110.