Green Card Medical Exam: Requirements and What to Expect

Every applicant filing Form I 485 for adjustment of status must complete a green card medical exam before USCIS will approve their application for lawful permanent residence. A USCIS designated civil surgeon conducts the exam, which includes a physical evaluation, mental health screening, vaccination review, and mandatory lab tests for communicable diseases. The results are recorded on Form I 693, the official medical document that gets submitted along with your I 485 petition.

Applicants who understand the full requirements and arrive prepared can finish the entire process in a single visit, while those who show up without proper documents or vaccination records often face delays and additional costs. This guide explains what the exam requires, what happens during the visit, and what to expect after it is complete.

What Is the Green Card Medical Exam and Why Is It Required?

The green card medical exam is a mandatory health screening required under Section 212(a) of the Immigration and Nationality Act for every applicant seeking lawful permanent resident status in the United States. USCIS uses this exam to confirm that applicants meet the health related admissibility standards established by U.S. immigration law and the Centers for Disease Control and Prevention. Without a completed Form I 693 from a designated civil surgeon, USCIS will not process your I 485 application.

Congress established this requirement to protect public health and ensure that all immigrants meet the same medical standards before receiving a green card. The exam screens for communicable diseases of public health significance, substance use disorders, and mental health conditions that may pose a risk to the applicant or the public. For a detailed walkthrough of the form, read our detailed resource on Form I 693 that state what it is and how to fill that form.

Only a USCIS designated civil surgeon has the legal authority to perform this exam and sign Form I 693. Regular physicians, urgent care clinics, and hospitals cannot complete immigration medical paperwork. You can find a designated civil surgeon near you through the Find a Doctor tool on the USCIS website. To learn more about the designation, read our blog on Civil Surgeon.

Who Needs a Green Card Medical Exam?

Every applicant filing Form I 485 for adjustment of status inside the United States must complete this exam regardless of age, health status, or country of origin. This requirement applies to family based applicants, employment based applicants, diversity visa winners, and special immigrant categories. There are no exemptions based on how long you have lived in the country or whether you had a previous medical screening.

Applicants who completed a medical exam at a U.S. embassy or consulate abroad may still need a new one if the original results have expired. Form I 693 is valid for two years from the date the civil surgeon signs it. If USCIS does not receive the form before that window closes, you must repeat the green card medical exam at your own cost and start the process over.

Children, adults, and elderly applicants all follow the same general process, though the vaccination requirements differ by age group. The CDC sets specific immunization panels based on age, and the civil surgeon checks your records against the panel that applies to you. Applicants under 18 and those over 65 may have shorter or longer vaccine checklists depending on what the CDC recommends for their category.

What Happens During the Green Card Medical Exam?

The appointment begins with a document review. The civil surgeon verifies your identity using a government issued photo ID and confirms your case details with your I 94 arrival record, A number, and I 485 receipt notice. Your vaccination records are then reviewed against the CDC required immunization panel for your age group. Complete records save significant time because the doctor can verify past immunizations without ordering additional blood work. For a step by step preparation checklist, read our guide on the immigration medical exam.

The physical evaluation covers your eyes, ears, skin, heart, lungs, abdomen, lymph nodes, and extremities. A mental health screening and substance use assessment are standard parts of every appointment. The civil surgeon then orders three mandatory lab tests: a TB blood test known as the IGRA, a syphilis test called the RPR, and a gonorrhea test. There is no fasting requirement for the exam, so eat and drink normally before your visit.

Your vaccination history is one of the most important parts of the process. Adult applicants typically need proof of MMR, Tdap, varicella, hepatitis A, hepatitis B, polio, and seasonal influenza vaccines. As of January 2025, the COVID 19 vaccine is no longer on the required list. Applicants with missing records may need titer blood tests to confirm immunity or catch up doses for any gaps in coverage. For the full vaccine breakdown, read our guide on the USCIS medical exam.

Cost, Timeline, and What Happens After the Exam

Once lab results return, the civil surgeon completes the remaining sections of Form I 693, classifies any findings as Class A or Class B, signs the certification, and seals the form in an envelope. Do not open this envelope under any circumstances. USCIS rejects any Form I 693 that arrives with a broken seal, and you will need to redo the entire exam at your own expense.

The total cost for the exam ranges from $200 to $500 depending on the civil surgeon’s fee, lab work, and any catch up vaccinations you need. Most health insurance plans do not cover immigration medical exams because this is considered an immigration requirement rather than a standard medical service. Lab results typically return within three to five business days, and most applicants receive their sealed form within one to two weeks after the appointment.

At Prime Healthcare of Cypress, we provide immigration physicals in Cypress and our civil surgeon handles the full process from the physical evaluation and lab work to the vaccination review and Form I 693 completion for your green card medical exam in Cypress. Here is how the exam process compares for prepared and unprepared applicants.

Frequently Asked Questions