Medical Examination: Frequently Asked Questions (FAQs)

General Information

Medical Examinations

What is CDC’s role in medical examinations?

The Centers for Disease Control and Prevention (CDC) is responsible for providing the technical instructions to Civil Surgeons and Panel Physicians who conduct medical examinations for immigration. These instructions are developed in order to implement the Immigration and Nationality Act (INA) regulations regarding the health-related grounds for inadmissibility of persons applying for admission into the United States.

What is the purpose of the medical examination?

The purpose of the medical examination is to identify applicants with inadmissible health-related conditions for the Department of State (DOS) and U.S. Citizenship and Immigration Services (USCIS). The health-related grounds for inadmissibility include persons who have a communicable disease of public health significance, who fail to present documentation of having received vaccination against vaccine-preventable diseases, who have or have had a physical or mental disorder with associated harmful behavior, or who are a drug abuser or an addict.

Who is required to have a medical examination for migration to the United States?

Source: U.S. Department of Homeland Security
* Others include migrants who entered the United States without inspection, including those who entered with and without proper documentation

All immigrants, refugees and certain nonimmigrants, including fiancés, coming to the United States must have a physical and mental examination abroad by a Panel Physician. Persons in the United States applying for adjustment of status to a permanent resident of the United States must have a physical and mental examination in the United States by a Civil Surgeon.

What does a medical examination entail?

The medical examination procedure consists of a physical examination, an evaluation (skin test/chest x-ray examination) for tuberculosis, and blood test for syphilis. The vaccination requirements include vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).

The technical instructions indicating the required testing, the diseases currently listed as being communicable diseases of public health significance, and the vaccination requirements are available on the CDC website.

Additional immigration information and regulations are available on the USCIS website: http://www.uscis.gov/portal/site/uscis

What are the communicable diseases of public health significance that would cause an applicant to fail a medical examination or be inadmissible?

Communicable diseases of public health significance include—

• Tuberculosis
• Syphilis
• Gonorrhea
• Hansen’s Disease (Leprosy)

And the following two disease categories–

• Quarantinable diseases designated by any Presidential Executive Order. Current diseases include: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and influenza caused by novel or re-emergent influenza (pandemic flu).
• Events that are reportable as a public health emergency of international concern (PHEIC) to the World Health Organization (WHO) under the International Health Regulations (IHR) of 2005 (currently polio, smallpox, SARS, influenza, and other public health emergencies of international concern.)

Some health-related waivers may be available for these diseases. For general information concerning the role that the CDC plays in the waiver process, you may visit our website. Additional information concerning Form I-601, the waiver application, and the requirements is located on the U.S. Citizenship and Immigration Services (USCIS) website.

What vaccines/boosters are required for immigrants and those applying for adjustment of status in the United States?

As part of the medical examination for immigration, all immigrants are required to have an assessment for the following vaccine-preventable diseases: mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, Haemophilus influenzae type B, rotavirus, hepatitis A, hepatitis B, meningococcal disease, varicella, influenza, and pneumococcal pneumonia. Persons already in the United States applying for adjustment of status for permanent residency, including refugees, are also required to be assessed for these vaccine-preventable diseases.

Each set of Technical Instructions for medical examination of aliens has an addendum regarding the vaccination requirements for immigrants.

Do all vaccine series have to be completed before vaccination requirements are fulfilled?

For vaccines requiring a series, only a single dose is required for immigration purposes. However, the Civil Surgeon should check the “insufficient time interval” box on the I-693 Form, and also advise the applicant to complete the series in the future.

Could a person request and be granted a personal-belief waiver from the vaccine requirements?

The applicant needs to check with USCIS to obtain the application for a waiver based on religious or moral conviction. It is a separate application process to obtain an individual waiver based on religious or moral conviction.

Forms

Where does one find a list of Civil Surgeons who do the medical examination for adjustment of status?

A list of Civil Surgeons (doctors in the U.S. who perform medical examinations for persons adjusting their status to permanent residency) is available on the USCIS website: http://www.uscis.gov/portal/site/uscis

How does one request the I-693 Medical Examination Form?

The I-693 form is available on the USCIS website: http://www.uscis.gov/portal/site/uscis

How does one request the Department of State (DOS) medical examination forms and associated worksheets for immigrant visa applications?

The Department of State (DOS) forms for medical examination of immigrant visa applicants (DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026) are not available on the CDC website.

Since the forms are DOS forms, information about obtaining these forms may be requested on DOS website: https://travel.state.gov/content/travel/en.html

For Civil Surgeons

How does one request the Technical Instructions for Civil Surgeons?

The Centers for Disease Control and Prevention (CDC) is responsible for providing the technical instructions to Civil Surgeons conducting medical examinations for immigration.

The instructions, along with important updates, are available on our website.

General information concerning Civil Surgeons and the medical examination required for immigration purposes is also available on the USCIS website.

What does the blanket designation of health departments as Civil Surgeons mean?

The blanket designation of health departments as Civil Surgeons applies only to the vaccination assessment and only to refugees. Also, only health departments that have a physician or physicians meeting the legal definition of Civil Surgeon can participate in this designation, and accepting the designation is entirely voluntary on the part of health departments. A Civil Surgeon is legally defined as a licensed physician with no less than 4 years of professional experience.

The completed I-693 medical examination form must contain the official stamp or seal of office and be given to the refugee in a sealed envelope for presentation to the U.S. Citizenship and Immigration Services (USCIS). The form must also be signed by a health department physician who has at least 4 years of professional experience.

The technical instructions for civil surgeons, in their entirety, are available on CDC’s website.

The vaccination section of the technical instructions includes information on the blanket designation of health departments as Civil Surgeons for the vaccination assessment of refugees, as well as the instructions for completing the vaccination assessment for refugees.

I need to make changes to our Civil Surgeon listing. How do I do that?

You must contact the U.S. Citizenship and Immigration Services (USCIS) concerning request for changes to the civil surgeon listing including address, phone number, and addition of physicians in your office. To locate the nearest USCIS office for your area, visit the USCIS website: http://www.uscis.gov/portal/site/uscis

How does one become a Civil Surgeon? What are the requirements for a Civil Surgeon?

Civil Surgeons are designated by the District Director of the U.S. Citizenship and Immigration Services (USCIS). Immigration regulations state that each civil surgeon selected shall be a licensed physician with no less than 4 years of professional experience. A written request for Civil Surgeon designation along with evidence of the requirements should be directed to the appropriate USCIS office.

CDC is responsible for providing the technical instructions to Civil Surgeons conducting medical examinations for immigration. The instructions, along with important updates, are available on our website.

Contact information for the USCIS office located in your area is available on the USCIS website: http://www.uscis.gov/portal/site/uscis

Our site would like to be registered to do immigration physicals. Where can we apply?

Physicians (i.e., civil surgeons) who perform the examination for immigrants or nonimmigrants applying for adjustment of status for permanent residency in the United States need to contact the US Citizenship and Immigration Services (USCIS). Civil Surgeons are designated by the District Director of USCIS. Information concerning USCIS district offices, as well as contact information for those offices, is available on the USCIS website: http://www.uscis.gov/portal/site/uscis

For Panel Physicians

How does one request the Technical Instructions for Panel Physicians?

The Centers for Disease Control and Prevention (CDC) is responsible for providing the technical instructions to Panel Physicians conducting medical examinations for immigration.

The instructions, along with important updates, are available on our website.

Where does one find detailed instructions for completing the Department of State medical examination forms and associated worksheets for immigrant visa applicants?

The Department of State (DOS) forms for medical examination of immigrant visa applicants, (DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026) are not available on the CDC website.

Since DS-2053, DS-2054, DS-3024, DS-3030, DS-3025, and DS-3026 are DOS forms, information about obtaining these forms should be requested on the DOS website: https://travel.state.gov/content/travel/en.html

How long is the overseas medical examination of aliens valid?

The length of time medical examinations are valid vary. The Tuberculosis Screening and Treatment Technical Instructions (TB TIs) using Cultures and Directly Observed Therapy (DOT) for Panel Physicians determine the validity of the required medical examination.

Medical examinations are valid for 6 months for individuals with the following conditions:

• No Class (i.e., No Apparent Defect, Disease, or Disability)
• Class A Other than TB
• Class B2 Latent TB Infection (LTBI)
• Class B3 TB (Contact Evaluation)
• Class B, all except TB, including specific Class B conditions
• Class B Other conditions

Medical examinations are valid for 3 months for individuals with the following conditions:

• Class A TB with Waiver
• Class B1 TB, Pulmonary
• Blass B1 TB, Extrapulmonary
• HIV infection

How does one become a Panel Physician?

Panel Physicians are selected by U.S. Department of State (DOS) embassies and consulates. Therefore, you should contact the appropriate American Embassy or Consulate for information on how to become a Panel Physician. Contact information for those offices is available at http://usembassy.state.gov/

CDC is responsible for providing the technical instructions to Panel Physicians conducting medical examinations for immigration. Those instructions, in their entirety, are available on our website.