At e7 Health, we offer Immigration Medical Exams that include all aspects of the medical exam according to the US Department of Health and Human Services' regulations. We will complete all the requirements of Form I-693. We offer same day or next day appointments and allow you to book your appointments online!
Our clinic has a designated Civil Surgeon authorized by the U.S. Department of Homeland Security, U.S Citizenship and Immigration Services (USCIS). By this designation, the Civil Surgeon is authorized to perform medical examination and give necessary immunization for noncitizens applying for adjustment of status or Permanent Resident Status (Green Card). Individuals applying for citizenship, seeking Permanent Residency, or a Green Card may be required to obtain an immigration physical prior to approval of their application.
Do you need a USCIS Immigration Medical Examination?
A medical examination is a necessary part of the application process for applying for adjustment of status. The purpose of the examination is to evaluate the health of the person and identify the presence or absence of certain disorders that may require follow-up medical care. The Civil Surgeon does not determine if a person is eligible for adjustment of status; that determination is made by the Immigration officer after reviewing all records, including the report of the medical examination.
There are many requirements to be met and our expert medical staff can assist you through this process quickly and efficiently.
What to bring with you for your appointment:
- Valid Government Issued ID: Passport, US Driver’s License, State ID
- Proof of prior vaccinations (if available) including a completed Covid-19 Immunization record
- If previously tested positive for Tuberculosis or treated for Tuberculosis, records of the test results and/or treatment completion
- Immigration Physical Form I-693, with Part 1 completed in black ink only. It must be done in ALL CAPITAL letters WITHOUT ERRORS. Do not sign this form until the Civil Surgeon instructs you.
What the I-693 Form Requires
Medical Examination by a Certified Civil Surgeon
During the medical examination, a medical history and physical examination is performed. The focus of the medical history and examination is on communicable diseases such as Tuberculosis, Syphilis and Gonorrhea. During the medical history, the examiner will ask about previous illnesses, surgeries, signs and symptoms of any communicable diseases, and mental health. There will be a medical examination that includes a head to toe physical such as examination of your head, neck, heart, lungs, etc. Your blood pressure, temperature, pulse and respirations will be measured.
Also, during the medical history, any pertinent medical records you provide on previous vaccinations received, previous tuberculosis tests or other records pertaining to components of the exam will be reviewed.
Completion of USCIS Required Immunizations (all vaccines are available in our office for your convenience)
Vaccination requirements for applicants follow criteria determined by the Centers for Disease Control and Prevention (CDC). At e7 Health, we always carry all vaccines available in the US unlike some other immigration medical offices. This saves you time for having to go search at other clinics for vaccines and streamlines the medical examination process.
Vaccines that are required are determined based on if they are age-appropriate, protect against a disease that has the potential to cause an outbreak, protect against a disease that has been eliminated in the US or is in the process of being eliminated in the US.
Applicant's vaccine records will be reviewed and documented on the I-693 form in the vaccination section. If the vaccination record is not in English, it must be translated by an official translator per USCIS requirements.
Immunizations required for the Vaccination portion of the medical examination are individually determined based on:
- Applicant's medical history and vaccination records
- Laboratory testing for immunity
- Our office can perform a blood test called a titer to check for immunity for some illnesses/vaccinations you may have received before such as Chickenpox (Varicella), Measles, Mumps, Rubella, Hepatitis A and Hepatitis B
- During the examination, the applicant is assessed for contraindications and precautions to any vaccines for safety
- Previous vaccinations and any vaccinations given by the Civil Surgeon are documented on the form I-693
- A record of the vaccinations is provided to the applicant to keep and are entered into the State immunization database
Required blood and urine testing
The I-693 form requires that applicants 17 and older have a test performed for Syphilis or Gonorrhea, based on age and any signs or symptoms. Syphilis and Gonorrhea are both Sexually Transmitted Diseases that can be contagious and are also still a common infection throughout the world. Some applicants may not have symptoms of the disease, so the test is required to ensure that anyone who is infected be treated and will not be contagious in the US.
The Syphilis test is done through a blood test called an RPR. If the results are normal, there is no Syphilis and that section of the examination if completed. If the results are abnormal, the laboratory will be able to run a second test with the same blood sample to verify if the results are truly abnormal. If the second test called a T. Pallidum-PA is abnormal, then the applicant should be treated for Syphilis before finishing the examination forms. At e7 Health, we can provide the treatment for Syphilis if needed.
The other test for Gonorrhea is done through a simple urine test. If the results are normal, that portion of the examination is complete. If the results are positive (abnormal), then the applicant should be treated.
Gonorrhea and Syphilis treatment are specific antibiotics that should be given in the proper way to ensure that the applicant will be cured. We follow the CDC Guidelines in the proper treatment and antibiotics to provide if needed.
Tuberculosis is caused by a bacterium called Mycobacterium tuberculosis. Tuberculosis most often infects the lungs but can sometimes infect other parts of the body. Tuberculosis infections do not always make a person sick right away. There is a type of dormant infection called latent tuberculosis (TB) infection. The other type of infection is TB disease, which can be fatal if not treated. TB disease can occur within weeks of being infected or can occur years later, when the person's immune system becomes weaker.
Tuberculosis is extremely common. Unfortunately, one-third of the world's population is infected with tuberculosis and is at risk of developing the disease. Therefore, it is a requirement for the immigration medical examination.
USCIS requires a tuberculosis test for all applicants 2 years old or older. Applicants with certain medical conditions that suppress their immune system or applicants with signs or symptoms of tuberculosis disease must also have a chest x-ray.
The type of tuberculosis test performed is called QuantiFERON. Previously, the most common test for tuberculosis was a tuberculosis skin test (TST). Immigration no longer allows the use a TST. The benefits to the QuantiFERON over the skin test are that it is a simple blood test performed in one visit. The TST required a second visit in 48-72 hours to check the results. The QuantiFERON is also not affected by a common vaccine given in many countries for Tuberculosis called the BCG vaccine. The TST could result in a false-positive for applicants who have had the BCG vaccination.
A chest x-ray is required for a positive IGRA result to evaluate for tuberculosis disease. If the chest x-ray result does not have any indication of tuberculosis infection, the application can be completed. If the chest x-ray result indicates suspicion of tuberculosis disease, the applicant must be referred to the health department for further evaluation.
Completion of Form I-693
The I-693 form is the form used from the Department of Homeland Security to report the results of the medical examination for USCIS. There is a small section of the form for the applicant to complete. Much of the form is completed by the Civil Surgeon and once completed is sealed in an envelope containing other pertinent medical records such as the applicant's lab results, vaccine records and chest x-ray if applicable.
The I-693 applicant section can be completed prior to the appointment or in the office. The instructions for the form can be found here.
View Form I-693 Instructions
The Medical Examination includes the cost of the Quantiferon blood test, Syphilis blood test and Gonorrhea Urine test. Additional services that may be required (such as required vaccinations and follow-up chest x-ray for positive TB testing) are not included in the price of the exam but are offered for an additional fee based on an individual's health information and medical records.
Download Form I-693
When testing and medical examination is completed, you will receive:
- A sealed envelope containing the results of the medical examination and all required laboratory tests on the I-693 forms.
- An official immunization record from the state database and x-ray report (if applicable) for your records.