Walking into your civil surgeon appointment fully prepared is the single most effective way to avoid unnecessary delays, repeat visits, and extra costs. The immigration medical exam is a critical step in your Green Card process, and the civil surgeon cannot complete your Form I-693 without the right documentation. Missing a single item—such as a valid photo ID or complete vaccination records—can result in a Request for Evidence (RFE) or force you to pay for vaccines you already received. This guide provides a comprehensive checklist of exactly what to bring, what to leave at home, and how to organize your documents for a smooth, one-visit experience.
Key Rule: You must bring a government-issued photo ID (such as a valid passport or driver’s license) and your vaccination records to the civil surgeon appointment. Do not sign Form I-693 before the appointment—you will sign it in the presence of the civil surgeon. The completed form must be placed in a sealed envelope; do not open it unless you are filing Form I-485 online.
Essential Documents Checklist
Bringing the right documents to your appointment ensures the civil surgeon can complete your exam efficiently and accurately. Below is a complete checklist of everything you need.
| Document | Specification | Why It Matters |
|---|---|---|
| Government-Issued Photo ID | Valid passport, U.S. or foreign driver’s license, state ID, national ID card, or Employment Authorization Document (EAD) | Confirms your identity; the civil surgeon will use the name on your ID for Form I-693 |
| Form I-693 (Blank, Unsigned) | Download the most recent edition from the USCIS website; complete Parts 1 and 2 but do not sign | The civil surgeon completes the form during the exam; you must sign it in their presence |
| Vaccination Records | Official records showing vaccine names and complete dates (Month/Day/Year) | Saves you from paying for duplicate vaccines; records must be legible and include your full name and date of birth |
| Medical History Records | Details of past illnesses, surgeries, hospitalizations, chronic conditions, and mental health history | Helps the civil surgeon accurately assess your health and document any Class B conditions |
| Current Medications List | Complete list of medications, dosages, and reasons for use | Essential for the civil surgeon to evaluate your overall health and medication history |
| Prior Test Results | Previous TB test results, syphilis or gonorrhea treatment records, or lab reports | Prevents repeat testing and provides evidence of past treatment or immunity |
| Health Insurance Card | Your current health insurance card, if applicable | Some civil surgeons accept insurance for vaccine administration; the exam fee itself is often not covered |
| Payment | Check, credit card, or cash—confirm accepted methods with the civil surgeon’s office | Fees vary widely; the exam typically costs $200–$500, plus additional costs for vaccines and lab tests |
| Name Change Documents (if applicable) | Marriage certificate or court order for legal name changes | Ensures the name on your ID matches the name used on Form I-693 |
| Appointment Confirmation | Appointment letter or confirmation from the civil surgeon’s office | Required to begin the medical exam at many clinics |
What If You Don't Have Vaccination Records?
Not having your vaccination history is not a roadblock—it simply means you will need to take a different path. If you cannot locate your records, the civil surgeon has two options:
- Titer Tests: The civil surgeon can order blood tests to check for immunity to diseases like measles, mumps, rubella, and varicella. If the tests show immunity, you do not need the vaccine.
- Receive Vaccines During the Exam: The civil surgeon can administer the required vaccines on-site. You are only required to receive at least one dose of each age-appropriate vaccine during the exam; you can complete the remaining doses later.
If you have a DS-3025 from a prior visa application (such as a K-1 visa), bring it to your exam. This form serves as your official vaccination record and can be transcribed onto Form I-693 by the civil surgeon.
Step-by-Step Process: What Happens at the Appointment?
Understanding the flow of the appointment helps you know what to expect and what documents the civil surgeon will need at each stage.
- Check-in and identity verification: The civil surgeon or their staff will verify your identity using your government-issued photo ID. If your name has changed, they will ask for supporting legal documents.
- Form I-693 review and signature: You will present your blank, unsigned Form I-693. The civil surgeon will review it, and you will sign it in their presence. Do not sign the form before the appointment.
- Medical history review: The civil surgeon will ask about your past and present medical conditions, surgeries, hospitalizations, medications, and mental health history. Bring any relevant medical records to support your answers.
- Physical examination: The civil surgeon will perform a physical exam, including checking your height, weight, blood pressure, and vital signs.
- Vaccination assessment: The civil surgeon will review your vaccination records against the CDC requirements. If you are missing any required vaccines, they will administer them during the exam.
- Lab tests: The civil surgeon will order required tests, including a TB screening (IGRA blood test) for applicants aged 2 and older, blood tests for syphilis (for applicants aged 15–44), and a urine test for gonorrhea (for applicants aged 15 and older).
- Completion and sealing of Form I-693: Once all tests and vaccinations are complete, the civil surgeon will complete, sign, and seal Form I-693 in an envelope. Do not open this envelope unless you are filing Form I-485 online. The civil surgeon should give you a copy of the completed form for your personal records before sealing the envelope.
Most exams require one visit for tests and a follow-up for results, though some civil surgeons can complete everything in a single appointment if lab results are available quickly.
Costs and Payment Information
The cost of the immigration 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 Component | Estimated Range | Notes |
|---|---|---|
| Civil surgeon exam fee | $200 – $500 | Varies by location and provider |
| Vaccines (if needed) | $20 – $150 per dose | Depends on which vaccines you still need |
| IGRA blood test (TB) | $100 – $190 | Required for applicants aged 2 and older |
| Syphilis blood test | $20 – $50 | Required for applicants aged 15–44 |
Key tip: Call several civil surgeons to compare prices before booking your appointment. Fees can vary by several hundred dollars. Most health insurance plans do not cover the immigration medical exam itself, but they may cover vaccine administration. Confirm accepted payment methods (cash, credit card, check) with the civil surgeon’s office before your appointment.
Common Mistakes to Avoid
Even with the right documents, small errors can lead to delays or additional costs. Avoid these common pitfalls:
- Signing Form I-693 before the appointment. You must sign it in the presence of the civil surgeon—an unsigned or pre-signed form will be rejected.
- 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.
- Bringing an outdated edition of Form I-693. Always download the most recent edition from the USCIS website before your appointment.
- Not bringing a valid photo ID. The civil surgeon cannot verify your identity without proper identification. If you are under 14, bring a birth certificate and a parent’s ID.
- Opening the sealed envelope. If you file by mail, the envelope must remain sealed—opening it invalidates the exam. If you file online, you must open it to upload the form.
- Not bringing medical history records. If you have a history of TB, mental health conditions, or chronic illnesses, bring supporting documentation to avoid repeat testing.
Frequently Asked Questions
Q: Can I bring my vaccination records from another country to the civil surgeon?
A: Yes. USCIS routinely accepts international vaccination records. The records must be legible, include your full name and date of birth, specify the exact vaccine name, and include the complete date of administration (Month, Day, Year). If the records are not in English, you must provide a certified translation.
Q: What if I don't have any vaccination records at all?
A: You can still complete the medical exam. The civil surgeon can either administer the required vaccines during the exam or order titer tests to check for immunity. You are only required to receive at least one dose of each age-appropriate vaccine during the exam; you can complete the remaining doses later.
Q: Do I need to fill out Form I-693 before my appointment?
A: You should complete Parts 1 and 2 of Form I-693 before your appointment, but do not sign the form. You will sign it in the presence of the civil surgeon during the exam.
Q: How much does the immigration medical exam cost?
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 $20 to $150 per dose, and the IGRA blood test for TB can cost $100–$190.
Q: What happens if I open the sealed envelope from the civil surgeon?
A: If you file by mail, opening the envelope invalidates the exam, and USCIS will not accept the form. If you file online, you must open the envelope to upload the form, but you must keep the original for your records.
Q: Can I use my health insurance to pay for the exam?
A: Many health insurance plans do not cover the immigration medical examination itself, but they may cover vaccine administration. Check with your insurance provider and the civil surgeon’s office before your appointment.
Q: What if my name has changed since my last ID was issued?
A: Bring legal documentation of your name change, such as a marriage certificate or court order. The civil surgeon will use the name on your current ID when completing Form I-693.