If you are applying for a green card or adjusting your immigration status in the United States, one requirement you cannot skip is the immigration medical exam. For many applicants, this step feels unfamiliar and a little stressful — especially when you are not sure what to expect, what documents to bring, or how the results will affect your application. The good news is that for the vast majority of people, this exam is straightforward and completed in a single visit.
At 360 Urgent Care Clinic in Wilmington, MA, our USCIS-designated civil surgeon guides you through every step with care, accuracy, and efficiency. This walkthrough covers exactly what the exam involves, what you need to prepare, and what happens after your visit — so you can walk in informed and walk out ready to file.
What Is an Immigration Medical Exam and Who Needs One?
The immigration medical exam, also called the USCIS medical examination, is a health evaluation required by U.S. Citizenship and Immigration Services (USCIS) for most applicants filing Form I-485 (Application to Register Permanent Residence or Adjust Status). Its purpose is to confirm that you do not have any health conditions that would make you inadmissible to the United States under immigration law.
The exam must be conducted by a USCIS-designated civil surgeon — a licensed physician authorized by USCIS to perform these evaluations. Your personal doctor, a general urgent care provider, or any clinic not holding civil surgeon designation cannot complete this exam. The results are recorded on Form I-693, Report of Immigration Medical Examination and Vaccination Record, which is then sealed and submitted to USCIS along with your I-485 application.
As of December 2, 2024, USCIS now requires Form I-693 to be submitted at the same time as your Form I-485. Filing your green card application without it may result in outright rejection of your entire application. Do not wait until you receive a Request for Evidence (RFE) — get your exam done before you file.
What to Bring to Your Immigration Medical Exam Appointment
Being prepared on the day of your appointment saves time and prevents delays. Here is what you need to bring:
• Valid government-issued photo ID: Passport, U.S. driver’s license, or equivalent.
• Vaccination records: Any records you have, even if incomplete or in another language. Translated vaccine records are accepted.
• Form I-693 (partially filled): Complete Parts 1 through 4 with your demographic information. Do not sign the form before your visit — you must sign it in the presence of the civil surgeon.
• Medical history documentation: Records of prior treatments for tuberculosis, syphilis, gonorrhea, or any other relevant conditions, if applicable.
• An interpreter, if needed: The civil surgeon must be able to communicate with you. Bring someone who can interpret if you do not understand English.
Note: No fasting is required before the lab tests included in a standard immigration medical exam.
Step-by-Step: What Happens During the Exam
Here is exactly what takes place during a USCIS medical examination:
Step 1: Identity Verification
The civil surgeon or clinic staff will verify your identity by reviewing your photo ID and confirming that it matches the information on your Form I-693. This step is non-negotiable and required under USCIS guidelines.
Step 2: Medical History Review
The civil surgeon will review your health history, including any past or current communicable diseases, mental health conditions, drug abuse history, and previous treatments. You will be asked questions about your medical background. Answer honestly — this review is a public health safeguard, and the civil surgeon is not reporting general health information to immigration authorities beyond what is relevant to admissibility.
Step 3: Physical Examination
A thorough physical examination is conducted. This includes checking your eyes, ears, nose, throat, heart, lungs, abdomen, skin, lymph nodes, neurological function, and extremities. The civil surgeon looks for signs of communicable diseases or physical conditions that could affect your admissibility under immigration law.
Step 4: Required Lab Tests
Depending on your age, the following lab tests are typically required:
• Tuberculosis (TB) test — QuantiFERON blood test: required for all applicants.
• Syphilis test: required for applicants between ages 18 and 45.
• Gonorrhea test: required for applicants between ages 18 and 24, or older if there is relevant medical history.
• Chest X-ray: required if TB test results indicate the need, or for certain age groups.
Note: COVID-19 vaccination is no longer required as of January 22, 2025, per updated USCIS policy.
Step 5: Vaccination Review and Administration
The civil surgeon will review your vaccination records against the CDC-required immunization schedule for immigration purposes. If you are missing required vaccines, they can be administered on the spot. Required vaccines typically include MMR (measles, mumps, rubella), varicella, hepatitis A and B, influenza, Tdap, polio, meningococcal, and others depending on age. Bring any vaccination records you have — this reduces the number of vaccines you may need to receive.
Step 6: Mental Health and Substance Use Screening
The civil surgeon will screen for any mental health disorders or substance use issues that may be relevant to your admissibility. This is not intended to penalize applicants for seeking mental health treatment — it is specifically focused on conditions defined under immigration law as grounds for inadmissibility.
Step 7: Form I-693 Completion and Sealing
Once all components of the exam are complete, the civil surgeon fills out the remaining sections of Form I-693, signs it, and places it in a sealed envelope. You must not open this envelope under any circumstances. If the envelope arrives at USCIS unsealed, your application may be rejected, and you will need a new examination.
What Happens After Your Immigration Medical Exam?
Once the civil surgeon seals Form I-693, you are responsible for submitting it to USCIS yourself. As of December 2024, it must be included with your Form I-485 in the same mailing package.
As of June 11, 2025, Form I-693 is valid only for the duration of your pending Form I-485. If your application is denied or withdrawn and you need to reapply, a new immigration medical exam will be required.
If the civil surgeon identifies a condition during your exam, USCIS classifies it as either a Class A or Class B condition. A Class A condition — such as active tuberculosis or certain communicable diseases — may affect your admissibility and will require treatment or a waiver before your application can proceed. A Class B condition is a less severe health issue that is noted but generally does not prevent admission.
Most applicants complete the exam with no issues and receive their sealed Form I-693 on the same day or after lab results are returned, typically within a few days.
How to Find a USCIS-Designated Civil Surgeon Near Wilmington, MA
Not all clinics or physicians can perform the immigration medical exam. You must find a physician with official USCIS civil surgeon designation. You can search for a civil surgeon in your area using the USCIS Find a Civil Surgeon tool on the USCIS website.
360 Urgent Care Clinic at 234 Main St, Wilmington, MA 01887 is a USCIS-designated civil surgeon location serving applicants throughout the greater Wilmington and North Shore Massachusetts area. We keep pace with all USCIS and CDC policy updates, ensure Form I-693 is completed accurately to reduce the risk of an RFE, and handle your appointment with the professionalism and sensitivity this process deserves.
According to the CDC’s Technical Instructions for Civil Surgeons, civil surgeons must follow strict protocols when conducting these examinations and recording results — and the physical exam must be conducted in person. Telemedicine is not permitted for any part of the immigration medical examination.
Frequently Asked Questions
Can my regular doctor perform the immigration medical exam?
No. Only a physician who holds an active USCIS civil surgeon designation can complete Form I-693. Your personal doctor, a general practitioner, or a standard urgent care clinic without civil surgeon status cannot conduct this exam. Exams completed by non-designated physicians will be rejected by USCIS.
How much does an immigration medical exam cost?
Fees for the immigration medical exam are set by each civil surgeon individually and are not regulated by USCIS. Costs vary depending on the clinic, the number of vaccinations required, and any additional lab tests needed. Contact the clinic directly for current pricing before your appointment.
What if I don’t have my vaccination records?
Bring whatever records you have. If records are unavailable or incomplete, the civil surgeon will review your history and may administer missing vaccines during your visit. You will not be turned away for lacking records — but having them can reduce the number of vaccines and appointments needed.
How long does the immigration medical exam take?
Most exams take between 60 and 90 minutes for the clinical visit. Some lab results, particularly the QuantiFERON TB blood test, may take a few days to return. If results require a follow-up visit or additional vaccinations, a second appointment may be needed before Form I-693 can be signed and sealed by the civil surgeon.
Book Your Immigration Medical Exam in Wilmington, MA
The immigration medical exam is a required step in your green card application, but it does not have to be complicated. With the right civil surgeon, the process is efficient, clearly documented, and handled correctly the first time — reducing delays and protecting your application. 360 Urgent Care Clinic in Wilmington, MA is here to make that happen. Schedule your appointment today or call us to speak with our team before your visit.