The medical exam is one of the green card requirements that raises the most questions. Not because it's hard, but because nobody explains the order of things well. Here is the full path, from before the first visit to the moment the envelope reaches USCIS. If you still need to confirm that a doctor is authorized, start with our guide to USCIS-authorized doctors.
Step 1: before the first visit
Plan the timing. USCIS limits how much time can pass between the doctor's signature and filing your adjustment of status application. Check the current rule at uscis.gov/i-693 or ask your attorney before booking.
Gather your vaccine records. Look for childhood cards, records from your home country and pharmacy printouts. If you were vaccinated in Texas, you can request your history from the state registry, ImmTrac2.
Download the form. Fill in the applicant section at home, but don't sign it: you sign in front of the doctor.
Step 2: the first visit
During this appointment the doctor:
- Reviews your medical history and does a full physical, covering vision, hearing, skin, heart, lungs and mental health.
- Compares your records with the vaccines the CDC requires for your age.
- Orders lab work: a TB blood test from age 2 on, plus the syphilis and gonorrhea tests that apply to your age.
Bring a photo ID and, if you take medications, the list.
Step 3: the results
Almost always everything is normal and you go straight to step 5. Still, it helps to know what happens if not:
- Positive TB blood test. It doesn't mean you're sick; many people born in Latin America carry a latent infection from years ago. What follows is a chest X-ray to look at the lungs. If it's clear, the case moves forward. If there's any doubt, the doctor refers you to the health department for a fuller evaluation.
- Positive syphilis or gonorrhea. Antibiotic treatment must be completed before the doctor signs, and it's documented on the form. Once treated, neither is an obstacle to permanent residence.
Step 4: missing vaccines
The doctor will tell you exactly which ones you still need. Some can be given at the clinic and others at a pharmacy or health center; what matters is bringing proof. In certain situations a vaccine isn't required, for instance when it doesn't apply to your age or there's a medical contraindication. The doctor records that on the form.
Step 5: signature and envelope
Once every result and vaccine is in place, you sign the form in front of the doctor, who signs it and seals it in an envelope. Don't open it. Keep a copy if one is given to you separately.
Step 6: filing
The envelope goes in with your residence application, or later if USCIS asks for it. Follow your attorney's instructions or the USCIS letter.
At Clínica Hispana Cruz 4
We perform the I-693 immigration exam with a USCIS-designated physician, explaining each step in Spanish or English. Samples are drawn in our lab on the day of the visit, and we let you know when results are ready. Come in any day of the week without booking, at Suite 240, 10100 Beechnut St. Ask about the cost at (281) 588-0033.
For information only; not immigration legal advice.
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