If you are applying for a Green Card from inside the United States through adjustment of status, the USCIS-approved medical exam (documented on Form I-693) is a mandatory step that proves you are not inadmissible on health-related grounds. As of July 2026, the process has specific rules: you must schedule this exam with a USCIS-designated civil surgeon, bring the correct documentation, and understand that the exam must be submitted with your Form I-485—either in a sealed envelope for paper filings or uploaded for online filings. The civil surgeon you choose will conduct a physical examination, review your vaccination history, and administer any required vaccines you still need. This guide walks you through exactly how to find an approved doctor, what to bring, what to expect, and how to avoid costly mistakes.
Key Rule: Only a USCIS-designated civil surgeon can complete your immigration medical exam and sign Form I-693. Using a non-approved doctor will result in your exam being rejected. As of July 2026, the exam typically costs $200 to $500 for the base fee, with additional costs for required vaccines and lab tests.
How to Find a USCIS-Designated Civil Surgeon Near You
Finding an approved civil surgeon is straightforward if you use the official USCIS locator tool. Do not rely on general online searches or recommendations alone—only the USCIS tool guarantees that the doctor is currently authorized.
Step-by-step instructions to find a civil surgeon:
- Visit the USCIS website and navigate to the Find a Civil Surgeon page.
- Enter your zip code or address to generate a list of approved civil surgeons in your area.
- Review the profiles for each surgeon, including their address, contact information, and languages spoken.
- Contact the surgeons directly to confirm their availability, current fees, accepted payment methods, and whether they accept your health insurance.
The USCIS locator is the most reliable method for finding a civil surgeon. While you can also search online or ask for recommendations, always double-check with the doctor's office that their USCIS designation is still current. Some clinics may have outdated listings, so a quick phone call can save you from a rejected exam.
Scheduling Your Medical Exam: What You Need to Know
Once you have selected a civil surgeon, the next step is scheduling your appointment. The exam typically takes one visit, though additional testing (such as a TB skin test or chest X-ray) may require a follow-up. Here is what you need to do:
- Call the civil surgeon's office using the phone number provided in the USCIS locator.
- Ask about availability and schedule your appointment as early as possible—civil surgeons can have wait times of several weeks, especially in busy areas.
- Confirm what you need to bring to the appointment (see the checklist below).
- Inquire about the fee structure—some clinics charge a flat fee, while others bill separately for lab tests and vaccines.
- Ask about insurance coverage—while the immigration medical exam is often not covered by health insurance, some clinics may accept insurance for vaccine administration.
If you are filing Form I-485 by mail, you must submit the completed Form I-693 in the original sealed envelope provided by the civil surgeon. If you are filing online, you must open the sealed envelope and upload the completed form, but you must keep the original envelope and form until USCIS makes a final decision on your case.
What to Bring to Your USCIS Medical Exam
Arriving unprepared is one of the most common reasons for delays and additional costs. Bring the following items to your appointment:
| Item | Specification | Why It Matters |
|---|---|---|
| Government-issued photo ID | Passport, driver's license, or military ID | Verifies your identity for the civil surgeon. |
| Vaccination records | Official records with exact dates (month/day/year) | Saves you from paying for unnecessary vaccines. |
| Form I-693 (Part 1 completed) | Fill out Parts 1 and 2 but do not sign until instructed | Saves time during the appointment; the civil surgeon completes the rest. |
| Medical history records | List of current medications, past conditions, and surgeries | Helps the civil surgeon assess your health accurately. |
| Payment | Check, credit card, or cash (confirm with the clinic) | The exam fee is due at the time of service. |
| Eyeglasses (if you wear them) | Bring your prescription glasses | Used during the physical examination. |
If your vaccination records are in a language other than English, bring a certified translation along with the original documents. The civil surgeon will also accept vaccination records from other countries as long as they are official and include dates.
What to Expect During the Medical Exam
The immigration medical exam is a screening, not a comprehensive treatment visit. The civil surgeon will check for conditions that could make you inadmissible to the United States on health-related grounds. Here is what the exam typically includes:
- Medical history review: The civil surgeon will ask about your past and present medical conditions, hospitalizations, surgeries, medications, and any history of mental illness or substance abuse.
- Physical examination: A general physical assessment, including measurements of your height, weight, blood pressure, and a check of your eyes, ears, nose, throat, and extremities.
- Mental health screening: This part assesses for any mental disorders that could make you inadmissible.
- Lab testing: A TB test (skin test or blood test) is required for applicants 2 and older, with a chest X-ray if the test is positive. Blood tests for syphilis and urine tests for gonorrhea are required for applicants 15 and older.
- Vaccination review and administration: The civil surgeon will review your vaccination records against the CDC requirements. If you are missing any required vaccines, you will receive them during the exam (or be scheduled for follow-up doses).
As of January 2025, the COVID-19 vaccine is no longer required for immigration medical exams. However, other vaccines—such as MMR, Tdap, polio, varicella, hepatitis B, and seasonal influenza—remain mandatory based on your age.
After the exam is complete, the civil surgeon will provide you with a sealed envelope containing your completed Form I-693. Do not open this envelope unless you are filing Form I-485 online (in which case you must open it to upload the form). For paper filings, the envelope must remain sealed when you submit it with your application.
Costs, Fees, and What Determines the Price
The cost of the USCIS medical exam is not set by USCIS—civil surgeons set their own fees. As of July 2026, the total cost typically ranges from $200 to over $1,000, depending on several factors:
| Cost Factor | Estimated Range | Notes |
|---|---|---|
| Base exam fee | $200 – $500 | Varies by location and clinic |
| Vaccines | $50 – $300+ | Depends on how many vaccines you need |
| Lab tests | $50 – $200 | TB test, syphilis test, gonorrhea test |
| Follow-up visits | $50 – $300+ | If initial tests yield positive results |
To avoid unexpected costs, bring your complete vaccination records to the exam. If you have proof of all required vaccines, you will not need to pay for them during the exam. Some clinics also offer expedited services for an additional fee—for example, exams in Van Nuys, California start at $350 with expedited options available for $475.
Most civil surgeons require payment at the time of service. Confirm the accepted payment methods when you schedule your appointment—some clinics accept credit cards, while others require cash or money orders.
Common Mistakes That Delay Your Green Card Application
Even a small error in your medical exam process can trigger a Request for Evidence (RFE) and delay your application by months. Avoid these common pitfalls:
- Using a non-approved doctor. Only USCIS-designated civil surgeons can complete Form I-693. A regular doctor's exam will not be accepted.
- Opening the sealed envelope for paper filings. If you file by mail, the envelope must remain sealed. Opening it invalidates the exam, and you will need to start over.
- Filing Form I-485 before your exam is complete. As of December 2024, you must submit Form I-693 with your Form I-485. Filing without it will result in rejection.
- Submitting an outdated Form I-693 edition. As of July 2025, USCIS only accepts the 01/20/2025 edition. Using an older version will result in rejection.
- Not signing the form. An unsigned Form I-693 is automatically rejected. You must sign it in the presence of the civil surgeon.
- Forgetting to bring vaccination records. Without proof of prior vaccinations, you will need to pay for and receive them during the exam—adding significant cost and time.
- Waiting too long to schedule the exam. Civil surgeons can have wait times of several weeks. Schedule early to avoid delaying your entire application.
Frequently Asked Questions
Q: What is a civil surgeon, and why can't I use my regular doctor?
A: A civil surgeon is a physician who has been specifically designated by USCIS to conduct immigration medical examinations. Only these doctors are authorized to complete and sign Form I-693. Your regular doctor's exam will not be accepted by USCIS.
Q: How do I find a USCIS-approved civil surgeon near me?
A: Use the official USCIS Find a Civil Surgeon tool on the USCIS website. Enter your zip code to generate a list of approved doctors in your area.
Q: How much does the USCIS medical exam cost in 2026?
A: The base exam fee typically ranges from $200 to $500, but the total cost can be higher depending on required vaccines and lab tests. Additional costs for vaccines can range from $50 to $300 or more.
Q: What vaccines are required for the immigration medical exam?
A: Common required vaccines include MMR (measles, mumps, rubella), Tdap, polio, varicella, hepatitis B, and seasonal influenza. The COVID-19 vaccine is no longer required as of January 2025. The specific vaccines depend on your age.
Q: Can I file Form I-485 before completing my medical exam?
A: No. As of December 2024, you must submit Form I-693 with your Form I-485. Filing without it will result in rejection.
Q: What happens if I open the sealed envelope from the civil surgeon?
A: If you file by mail, the envelope must remain sealed. Opening it invalidates the exam, and you will need to complete a new one. If you file online, you must open the envelope to upload the form, but you must keep the original for your records.
Q: How long is the medical exam valid for?
A: Forms I-693 signed by a civil surgeon on or after November 1, 2023 are considered valid indefinitely while USCIS adjudicates the application. However, the exam must still meet the health requirements at the time of filing.