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​What does the Immigrate Exam Consist of?

An important part of obtaining a green card in the United States is getting an immigration medical exam. Immigrating to America and getting a green card can feel overwhelming at times, but here at Immigration Medical Center, we are here to help you through the process. We understand that becoming a citizen can be difficult and stressful, but we know that it is worth it, and we want to help you on your way there.

The Immigration Medical Exam

Although this medical exam does make sure the patient is in good health, it also has some specific differences from a normal doctor’s visit.

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Who can Perform this Exam?

Unlike other kinds of medical exams, this needs to be done by a doctor who is authorized by U.S. Citizenship and Immigration Services, also known as USCIS. The USCIS designates specific doctors to perform medical examinations for green card applicants, and these doctors are known as civil surgeons. Civil surgeons are experts in exactly what needs to be done to ensure your naturalization process goes as smoothly as possible.

There are, however, some exceptions to this rule. Military physicians are allowed to perform these immigration services, but only for U.S. veterans, members of the U.S. military, and their dependents. Furthermore, the medical exam must take place at a military treatment facility that is located within the United States. Some immigration exams can take place outside of the United States if they are done at a U.S. Embassy or consulate. The doctors who perform these are designated by the Department of State and are called panel physicians.

What Does the Exam Consist of?

It’s important to remember that the Immigration medical exam is not a comprehensive medical examination. The examination screens applicants for specific medical conditions. These conditions are specified by the U.S. Public Health Service specifically for U.S. immigration purposes.

So while you will be seeing a medical doctor, this examination shouldn’t replace a normal doctor’s visit. You shouldn’t expect to receive a diagnosis, consultation, or treatment for health conditions outside of those specified by the U.S. Public Health Service.

Medical History and Basic Exam

The civil surgeon will ask you about your medical history. It’s important to disclose any historical or chronic illnesses. The doctor will also do a physical examination that includes, at minimum, an examination of the eyes, the ears, the nose, the throat, arms and legs, the heart, the lungs, the abdomen, lymph nodes, the skin, and the external genitalia.

Tests and Disclosures

The medical examination will also include a chest x-ray and blood tests for syphilis. Children who are younger than 15 do not have to undergo the chest x-ray or blood tests, but they do need to have a general physical examination and immunizations.

When taking your medical history, the civil surgeon will need to know about some specific conditions.

Mental Health Problems

It’s important to be honest about any mental health problems you have experienced, even if they are in the past. If you have an intellectual disability or any learning disabilities, you need to bring a report that discusses and outlines any problems you have and any special requirements you may need in regards to education or supervision.

If you have ever been hospitalized or treated in any way for any psychiatric issues, or any drug or alcohol abuse, you need to bring to your examination a written certification that includes your diagnosis, the duration of the treatment you experienced, and a prognosis.

If you have a history of violent behavior that has ever resulted in injury to people or animals or property destruction, you need to bring information that will allow the civil surgeon to determine if these behaviors were related to any medical problem, psychiatric problem, or substance use. This includes any episodes of suicide attempts or self-harm behaviors.

Tuberculosis

If you have ever tested positive on a skin test for tuberculosis, you need to bring a certificate from a doctor. This needs to outline the circumstances of your positive skin test result and discuss any treatments that were done.

If you have ever had an abnormal chest x-ray, you need to bring the most recent chest x-ray films you have had done as well as the doctor’s report of the examination. And if you have ever been diagnosed with tuberculosis, you will need to bring written certification that has been signed by your doctor and that proves you have been adequately treated for tuberculosis. The certificate must have clear dates and names of medications listed.

Women who are pregnant must have the chest x-ray done in order to complete the immigration medical examination. The civil surgeon will provide abdominal and pelvic protection with a double-layered, wrap-around lead shield to protect her and the unborn child during the chest x-ray.

Syphilis

If you have ever had syphilis, you must bring a written certificate that has been signed by a doctor or a public health official that proves that you have been adequately treated for the syphilis. And if you have ever had a positive VDRL or other type of blood test for syphilis and were not treated, you need to bring a written explanation that has been signed by a doctor or public health official.

Chronic Medical Conditions

If you take medication or are otherwise being treated for an ongoing basis to treat a chronic medical condition, you need to bring a certificate specifying what medications you are on. It also needs to explain any ongoing diagnoses you have, any other treatments you have done, and your prognosis.

What Information Do I Need to Bring to the Medical Exam?

There are several things that you need to bring to your medical examination to make sure that everything goes smoothly.

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FORMS

You need to bring form I-693, which is the report of medical examination and vaccination record. This immunization record will include any vaccinations you have had, such as the DT, the DTP, DTaP, Td, Tdap, OPV, IPV, MMR, Hib, hepatitis A, hepatitis B, varicella, pneumococcal influenza, and meningococcal disease.

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ID

You need to bring government-issued photo identification. Those who are 14 years of age or younger need to bring an identification that shows their name, their date and place of birth, and the full name of their parents. Possible forms of this identification for youth include a birth certificate with an English translation or an affidavit.

It’s important that you also remember to bring medical insurance and a form of payment for the doctor’s office.

What Government Forms Do I Need to Bring?

The civil surgeon will not only provide a physical examination but will also help guide you through the paperwork process of naturalization. You should bring the following forms to your appointment:

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Form I-693

As we already discussed, this form is a record of your medical examination and vaccinations. This form is 14 pages long, and it is used to help the government establish that you are not inadmissible to the United States on public health grounds. You should use the most recent edition of the form, which is dated July 15, 2019.

Once your civil surgeon has completed your medical examination, they will give you the completed I-693 form in a sealed envelope. It’s important that you don’t accept the form unless they have placed it in a sealed envelope. This is because the USCIS will return the form to you if it is not in a sealed envelope or if the envelope has been opened or altered in any way. You, not your civil surgeon, must submit your I-693 form to the USCIS. You can submit your form by mail or in an interview at a USCIS field office. This form does not have a filing fee.

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Form I-485

This form is the Application to Register Permanent Residence or Adjust Status. This is the most commonly used form in the immigration process. It needs to be sent along with the I-693 in a sealed envelope. Like the I-693, the USCIS will send the form back to you if it is not in a sealed envelope or if the envelope has been altered.

The most recent edition of the I-485 is also dated July 15, 2019, however, the USCIS will also accept the December 13, 2017 edition. The fees for filing this form differ based on who you are.

If you are under the age of 14 and you are filing with at least one parent, then the fee is $750. If you are under 14 and not filing with a parent, the fee is $1,140. If you are 14 or older, the fee is also $1,140. If you are filing the form after being admitted to the United States as a refuge, there is no fee.

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Form N-648

This is the medical form for disability exceptions. This form is used if you are applying for U.S. citizenship but need to request an exemption from the English and civics testing requirements because of a disability. Disabilities can range from physical or developmental disabilities to mental impairment.

The edition of the N-648 that is accepted by USCIS is dated May 23, 2019. You need to submit this form with your completed N-400 form, which is the Application for Naturalization. There is no filing fee attached to the N-648.

Work Permit/Employment Authorization Document

In order to legally work within the United States, you need to have an Employment Authorization Document, and it is important that you bring this permit to your immigration medical exam. In order to obtain an Employment Authorization Document, you need to file Form I-765, which is the Application for Employment Authorization.

Conclusion

Immigrating to the United States and becoming a citizen can be an overwhelming process. There are many steps that you need to do in order to become naturalized, and these steps can feel stressful for anyone. We understand firsthand how difficult this time can be on anyone. That’s why at Immigration Medical Center we are dedicated to helping you through the process, not just the medical examination.

We are here to support you through this time by not only giving you medical care but also answering your questions pertaining to the naturalization process. We will help you gather the correct forms and get everything in order so that soon, you can say that you are a legal citizen of the United States of America. We know this process gets confusing, so we are here to help in any way we can.