What to Bring to Your Immigration Medical Exam

The Full Packing List at a Glance

If you file Form I-485 from inside the United States, USCIS requires a medical exam by a designated civil surgeon. The results go on Form I-693, Report of Immigration Medical Examination and Vaccination Record. The visit is usually short. Most delays come from missing paperwork, so pack your items the night before.

The standard exam includes a review of your medical and vaccine history, a physical exam, a tuberculosis blood test (IGRA) for applicants age 2 and older, a blood test for syphilis for applicants age 18 to 44, a urine test for gonorrhea for applicants age 18 to 24, and a mental health and substance use screening. A chest X-ray is only done if needed.

Here is the short list. The sections below explain why each item matters.

• A government photo ID, such as your passport
• Your vaccination records
• A list of the medicines you take now
• Past chest X-ray results, if you have any
• Payment for the exam fee

Your Government Photo ID (Bring Your Passport)

Bring a current passport or another government photo ID. The civil surgeon uses it to confirm your name, date of birth and other details that go on Form I-693. Small spelling differences between your ID and your other papers can cause trouble later, so it helps to catch them at the visit.

If you have a copy of your Form I-485 or your receipt notice, bring it too. It is not on the required list, but it helps the office match your file.

One more note. If you are applying from outside the United States through consular processing, you see a panel physician chosen by the U.S. Department of State, not a civil surgeon. The steps and paperwork can be a little different.

Your Vaccination Records, and What to Do If They Are Lost

Vaccination records are the item people most often forget. The civil surgeon has to record which vaccines you have had and which ones you still need. Required vaccines depend on your age and history. The list can include MMR, Tdap or Td, polio, hepatitis A and B, varicella, influenza during flu season, pneumococcal, Hib, meningococcal and rotavirus.

COVID-19 vaccination is no longer required for Form I-693 as of January 22, 2025.

Lost records are common, and your visit can still go forward. Try these steps first.

• Ask your childhood doctor's office, even if it has closed. Records often move to another practice or a state registry.
• Check with schools, colleges, former employers, the military or a pharmacy where you got a flu shot.
• Ask family members if they kept a baby book or old school forms.
• Tell the civil surgeon at the start of the visit. The doctor decides which vaccines you need based on your age and history and can tell you what to do next.
• Rules and vaccine requirements can change. Confirm the current list on uscis.gov before your visit.

A List of Your Current Medicines

Write down every medicine you take, including over-the-counter drugs, supplements and anything you take now and then. Note the dose if you know it. The exam includes a mental health and substance use screening, and your medicine list helps the doctor understand your health history.

Bring any records you have for ongoing conditions, like a recent lab result or a short note from your doctor. You do not need a full file. A plain summary in your own words is better than nothing.

Keep the list short and clear. One page is plenty. The civil surgeon can ask follow-up questions during the visit.

Old Chest X-Ray Results, If You Have Them

The exam usually includes a tuberculosis blood test (IGRA) for applicants age 2 and older. A chest X-ray is only needed if the TB test is positive or another issue comes up. If you had a chest X-ray in the past, bring the report or the film. It can save you a repeat test and some time.

Blood test results usually take a few days to two weeks to come back. The civil surgeon cannot finish Form I-693 until they have them, so plan for that wait when you pick an appointment date.

Payment for the Exam

USCIS does not set the price of the medical exam. Each civil surgeon sets their own fee. Total cost commonly runs from about $200 to $500 or more, depending on your city, the lab tests and how many vaccines you need. Health insurance often does not cover it.

Call the office before your visit and ask two things: how much the exam will cost and how they take payment. Then bring the payment with you.

If the price seems high, it is fine to call a second office. Fees vary a lot from one city to the next, and even within the same city. To compare civil surgeons near you, browse by city on our site.

Timing Tips Before You Go

Since December 2, 2024, USCIS generally requires Form I-693 to be filed together with Form I-485. A filing without it can be rejected. The civil surgeon must sign the form no more than 60 days before you file. That means you should book the exam close to your filing date, not months early. Leave room for lab results before you file.

After the exam, the civil surgeon gives you the completed Form I-693 in a sealed envelope. Do not open it. USCIS may reject a form that has been opened. Keep it flat and dry, and hand it to USCIS with your Form I-485.

Rules and fees can change. Check uscis.gov for the current Form I-693 rules, and use the Find a Civil Surgeon tool to confirm that a doctor is designated. Then compare civil surgeons by city on our site and pick one that fits your budget and schedule.