If you’re applying for a green card from inside the United States, the immigration physical exam is one of the few steps where a little preparation saves real money and time. The vaccine portion trips up the most people: missing records, unexpected shots, a form that comes back with a request for more evidence. Here’s what the exam covers, which vaccines are on the list, and how to show up ready.
Who Can Perform the Exam
Only a USCIS-designated civil surgeon can complete Form I-693, the Report of Immigration Medical Examination and Vaccination Record. Your regular doctor can’t do it, even if they’ve treated you for years. You can look up designated doctors with the USCIS civil surgeon locator. Many families in Houston, Katy and Cypress start by searching for an urgent care in Cypress or nearby, since walk-in clinics often keep flexible hours. Whatever clinic you choose, confirm the doctor’s civil surgeon designation before you book.
What the Exam Includes
These medical physical examinations follow technical instructions set by the CDC. Expect the following:
- A medical history review and a physical exam covering general health, heart, lungs, abdomen, skin and eyes
- Questions about mental health and any history of substance use
- TB screening, usually a blood test for people age 2 and older, with a chest X-ray if the result is positive
- A blood test for syphilis for applicants 15 and older
- A review of your vaccination records, with missing vaccines given when appropriate
Lab results can take a few days, so you may need a short follow-up visit before the form is completed.
Which Vaccines Are on the List
Which shots you need depends on your age and follows the CDC’s Advisory Committee on Immunization Practices schedule. Depending on age, the list generally includes:
- Measles, mumps and rubella (MMR)
- Varicella (chickenpox)
- Tetanus, diphtheria and pertussis (Td or Tdap)
- Polio
- Haemophilus influenzae type b (Hib) for young children
- Hepatitis A and hepatitis B
- Rotavirus for infants
- Pneumococcal vaccine for young children and older adults
- Meningococcal vaccine for adolescents
- HPV for age-eligible applicants
- Seasonal influenza during flu season
COVID-19 vaccination is no longer a requirement for the exam. The list is updated from time to time, so let the civil surgeon confirm what applies to you rather than relying on an old checklist.
Bring Records and Avoid Paying Twice
The civil surgeon can only count doses that are documented. Bring everything you can find: childhood immunization cards, school or military records, and anything from your home country. Records that aren’t in English need a translation. If you grew up in Texas, the state’s ImmTrac2 immunization registry may hold part of your history.
If records are missing, you may be able to prove immunity with a blood test for some diseases, or you may need to repeat doses. Some vaccines come in a series spread over weeks or months, so the earlier you start, the less stress you’ll have later.
When You Can’t Be Vaccinated
Some people have medical reasons to delay or skip a vaccine, such as pregnancy for live-virus shots, a serious allergy or a weakened immune system. In limited situations a medical exemption or waiver is possible, and the civil surgeon documents it on the form. Don’t assume you’re exempt. Raise it at the start of the visit.
Timing, Cost and the Sealed Envelope
Book your USCIS medical exam several weeks before you plan to file, since lab work and multi-dose vaccines take time. Insurance rarely covers this exam, so ask for pricing up front; fees vary by clinic and by which vaccines you still need. The civil surgeon hands you the finished form in a sealed envelope. Don’t open it, because USCIS can reject packets that look tampered with, and sign only when the doctor tells you to.
Rules about how long a signed I-693 stays valid and when it must be filed have changed in recent years. Check the current USCIS page or ask your immigration attorney before you schedule, so the timing works for your case.
FAQ
What is the USCIS medical exam?
It’s the health screening required for most people applying for lawful permanent residence from within the United States. A civil surgeon documents your health and vaccination status on Form I-693.
Is a regular physical exam enough?
No. A standard check-up from your own doctor won’t satisfy USCIS. The exam must be done by a designated civil surgeon and recorded on the official form.
How long does a green card medical examination take?
The visit itself usually runs 30 to 60 minutes. Lab results and any extra vaccine doses can add a few days to several weeks, depending on what you’re missing.
Conclusion
A smooth immigration physical exam comes down to three things: the right doctor, complete vaccine records and enough time before you file. Gather your paperwork early, ask the civil surgeon which vaccines apply to your age, and confirm the current USCIS filing rules.
Apex Urgent Care Clinic provides immigration medical exams with certified civil surgeons and serves patients across Katy, Cypress, Richmond and the Energy Corridor, so you can get your records reviewed and any needed vaccines handled in one place.
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