What to Expect at Your Immigration (Green Card) Medical Exam
Posted: Aug 30th, 2016 at 12:00AM
What to expect at your immigration (green card) medical exam
The immigration medical exam, also called the green card or I-693 medical exam, is conducted under United States Citizenship and Immigration Services (USCIS) guidelines and is used to see if you have any medical disqualifications for gaining your permanent legal residence adjustment of status to a United States citizen.
The medical exam has many different parts, all of which must be completed and signed off by a designated civil surgeon before it can be submitted to USCIS. Because there are so many parts to the exam, and very specific guidelines set out by USCIS, it is to your best benefit to use a clinic that specializes in immigration exams and offers all vaccines, lab work, and a designated civil surgeon in one place so that delays do not occur. Issues such as improper scheduling of vaccines, lab work, and tests can cause significant delays that could set back the entire citizenship process back by months.
e7 Health in both Las Vegas locations have experts on staff that understand the complicated immigration exam process and can schedule you for all necessary vaccines, lab work, and tests in one location. This can significantly cut down on the time required to complete your immigration exam. We also offer a designated civil surgeon in these locations to sign off on your exam. Watch out for clinics that claim to be able to perform your immigration exam, but do not offer all vaccines in their location, or do not specialize in the complicated procedures required for immigration exams.
Remember to bring any vaccine records and a government issued photo ID (driver's license or passport) to your initial appointment. Vaccine records must be in English, or include an English translation. In this case, and if a translator is needed to assist in filling out and/or translating the I-693 forms themselves, the translator must fill out the translator section (Part 2) on the I-693 form as must be present at your medical exam appointments to help the clinic staff communicate the process.
At our locations, you can expect your initial appointment to include the following services:
The I-693 Form
This is the form required by USCIS for all of your medical exam results to be recorded on. You can find the most up-to-date form on the USCIS website here along with instructions. This form can be filled out before your appointment, or you may fill out the form in our office before your appointment. The I-693 form must be filled out by typing your information into the form, or you may print your information using black ink and all capital letters only. If any mistakes are made on the I-693 form, a new page should be completed without errors. In our office, you will also fill out a health history form, sign a lab work consent, and fill out a short tuberculosis screening form. You will need at least 30 minutes to fill out all necessary paperwork before your immigration exam appointment, so plan to arrive early.
One of the required laboratory tests for the I-693 examination is a screening test for Tuberculosis. Previously, USCIS accepted either a Tuberculosis Skin test or Tuberculosis blood test. As of October 1st, 2018, the Tuberculosis skin test is no longer acceptable. Immigration will only accept a Tuberculosis blood test called an IGRA (Interferon Gamma Release Assay) test also known as a QuantiFERON. This test is required for applicants over 2 years of age, and all applicants under 2 years of age that have come into contact with a person who has tuberculosis or that are showing signs of tuberculosis.
If you have records of an abnormal tuberculosis skin test, tuberculosis blood test or tuberculosis treatment, those should be provided to the Civil Surgeon.
There are many benefits to the QuantiFERON compared to the (TST) Tuberculosis Skin test. Unlike the TST, which requires a return visit in 48-72 hours to check the injection site, the QuantiFERON is a simple blood test. Another benefit to the QuantiFERON is that the results are not affected like the TST by a vaccine given in some foreign countries called BCG. The BCG is a vaccine for Tuberculosis and it may cause false positive reactions in the TST, but not the QuantiFERON.
If the Tuberculosis test is abnormal, a chest x-ray is required to rule out active Tuberculosis infections in the lungs. If the chest x-ray results show that there is no active Tuberculosis in the lungs, then the application could be completed.
Syphilis Blood Test
All applicants age 15 and older are required to be tested for syphilis by USCIS, as well as applicants 14 and under who have symptoms of syphilis or a history of syphilis. The syphilis screening is a blood draw to determine if the applicant has syphilis disease. This blood draw must be done at the same time as the medical examination for immigration and at the civil surgeon's designated laboratory. Syphilis blood tests performed elsewhere prior to the immigration exam as not acceptable. If syphilis is detected in the sample, the applicant will need to be treated before the I-693 forms can be completed.
Gonorrhea Urine Test
All applicants age 15 and older are required to be tested for gonorrhea by USCIS, as well as applicants 14 and under who have symptoms of gonorrhea or a history of gonorrhea. The gonorrhea screening is a simple urine collection to determine if the applicant has gonorrhea disease. This urine collection must be done at the same time as the medical examination for immigration and at the civil surgeon’s designated laboratory. Gonorrhea tests performed elsewhere prior to the immigration exam as not acceptable. If gonorrhea is detected in the sample, the applicant will need to be treated before the I-693 forms can be completed.
The clinic will look over your vaccination records during your initial appointment to let you know if you will need vaccinations to complete your immigration medical exam. If you have received all required vaccinations and have all necessary records, you will not need to receive additional vaccinations to complete your immigration exam. If vaccines are required to complete your medical exam, they will be provided on the day of your exam, or rescheduled for a date in the near future if needed.
All vaccinations that are needed to complete the medical exam should be performed at the same location as your immigration medical exam so as not to delay the completion of your paperwork. Certain vaccines can interfere with other vaccines and with the tuberculosis requirement for the exam and delays can be caused when they are not done at the appropriate times. This is why it is important to have your immigration exam done at a location that can provide all vaccinations on site.
If you have received vaccinations in the past, but do not have your vaccination records you have the option of having blood titers drawn to prove your immunity. Blood titers are blood tests that can check for antibodies against certain diseases. If you have had a full series of a vaccination in the past, the blood titers will prove that you are immune to the disease and do not need the vaccinations. However, having a full series of a vaccination does not guarantee that your blood titers will show levels of antibodies that show immunity to a disease. Blood titers that show immunity to required diseases can be used in place of proof of vaccination by USCIS. If a blood titer comes back as not immune, the vaccination is then required.
Civil Surgeon Sign Off
The sign-off is typically a brief meeting with the designated civil surgeon to check your identity, look over your I-693 forms, ask any questions, and sign off on your paperwork.
Completion of Paperwork and Sealing of Packet
Once you have had your sign off with the designated civil surgeon and all of your paperwork has been completed, you will receive a sealed packet with all of the necessary paperwork to submit to USCIS. The medical office does not submit these forms for you. At our office, you will also receive a copy of all forms for your personal records. Make sure you do not open the sealed packet; this must be submitted to USCIS unopened. If the envelope arrives to USCIS opened or tampered with in any way, it will be rejected and returned to you, delaying your immigration process.
Our staff can assist you with any questions about the immigration medical exam process at the time of your initial appointment. Call our office today to get your INS medical exam process started at either of our Las Vegas locations by calling (702)800-2723, or book for medical exam online at e7health.com.
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