Route guide
The immigration medical exam for a green card: who needs it, who does it and what it covers
Every immigrant visa applicant, of any age, with narrow exceptions, such as certain Afghan special immigrants, has a medical examination before the visa is issued, done abroad by a panel physician chosen from the embassy or consulate’s list. People adjusting status inside the United States who must show they are not inadmissible on health grounds usually see a USCIS-designated civil surgeon instead and file the result on Form I-693. The exam looks, among other things, at communicable diseases of public health significance and checks the required vaccinations.
Official sources checked 12 October 2026; next check by 12 April 2027.
Who needs a medical exam?
For an immigrant visa, the rule has no age limit. Section 221(d) of the Immigration and Nationality Act (INA) requires the consular officer to have every immigrant visa applicant undergo a physical and mental examination before the visa is issued. 22 CFR 42.66 repeats this for “every alien, regardless of age”. So a principal applicant, their spouse and a newborn child applying together each need their own exam.
For adjustment of status (applying for a green card from inside the United States), the USCIS Policy Manual says applicants who must show they are not inadmissible on health-related grounds typically have the exam with a civil surgeon. USCIS’s family green card pages list Form I-693, Report of Immigration Medical Examination and Vaccination Record, “if applicable”.
Sources: INA 221(d), 8 U.S.C. 1201(d); 22 CFR 42.66; USCIS Policy Manual, Volume 7, Part A, Chapter 6, Section D.1; USCIS: Green Card for Immediate Relatives of U.S. Citizen
What the exam covers
The Department of Health and Human Services sets the scope in 42 CFR 34.3. Paragraph (a) tells medical examiners to consider, among other matters:
- Communicable diseases of public health significance.
- Documentation of vaccination against vaccine-preventable diseases, for anyone seeking admission as an immigrant or adjustment to permanent residence.
Sources: 42 CFR 34.3(a)
What happens at the appointment
9 FAM 302.2 describes a full exam as several components, including tuberculosis (TB) screening, vaccination, syphilis testing and a mental health and substance abuse assessment. The panel physician must have facilities for the required blood (serological) and X-ray tests or be able to refer the applicant to a qualified laboratory. Results go on State Department Form DS-2054 or DS-7794.
The detailed procedures are in the Centers for Disease Control and Prevention (CDC) technical instructions for panel physicians. Those pages are not among the sources cited here, so this page does not describe test-by-test requirements; check the CDC instructions and your embassy’s instructions.
Sources: 9 FAM 302.2-3(C) (medical examination validity); 22 CFR 42.66; 9 FAM 504.4-7 (medical examinations)
Required vaccinations
42 CFR 34.3(a)(2) names mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, Haemophilus influenzae type B and hepatitis B, plus any other vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for which the CDC finds a public health need. 9 FAM 302.2-6 lists the vaccines the CDC currently requires, many with age guidelines:
- Mumps, measles, rubella, polio, tetanus, diphtheria and pertussis.
- Haemophilus influenzae type B, rotavirus, hepatitis A and hepatitis B.
- Meningococcal disease, varicella, pneumococcal disease and influenza.
How many doses
9 FAM says applicants need at least one dose of each vaccine appropriate for their age. If a series was started but not finished, the next dose should be given. Finishing a whole series is not required, though applicants are encouraged to get as many doses as possible before travelling. Lacking a required vaccination makes an applicant ineligible for an immigrant visa under INA 212(a)(1)(A)(ii).
One exception is written into the rules: internationally adopted children aged 10 or under can receive their visa before vaccination if the adoptive parents sign an affidavit (Form DS-1981) promising vaccination within 30 days of arrival.
Abroad: the panel physician
Under 22 CFR 42.66, the applicant chooses a physician from a panel approved by the consular officer. 9 FAM 504.4 adds that the panel physician must be designated by the post for the consular district where the visa application is made. An exam from another district is accepted only in limited cases, such as a case transferred between posts after the exam.
The visa medical cannot be done in the United States, even for someone physically in the US who is applying abroad. The panel physician’s finding, or the CDC’s if the case is referred to it, binds the consular officer.
In the United States: the civil surgeon and Form I-693
An adjustment applicant sees a USCIS-designated civil surgeon, who records the results on Form I-693. USCIS says that if Form I-693 (or a partial I-693) is required, it must be filed with Form I-485; otherwise USCIS may reject the I-485.
The Policy Manual adds that someone who already had a medical exam overseas may not need to repeat it, or may need only the vaccination assessment. The officer checks that the I-693 is properly completed and its results are still valid.
Sources: USCIS Policy Manual, Volume 7, Part A, Chapter 6, Section D.1; USCIS: Green Card for Immediate Relatives of U.S. Citizen
How long results last
The CDC sets the validity of an exam done abroad, and 9 FAM 302.2-3(C) records it:
- Six months for most results, including no medical class and most Class B conditions.
- Three months for certain tuberculosis classes and for HIV infection.
- Not medically cleared to travel after a Class A TB finding without a waiver, until treatment succeeds.
Sources: 9 FAM 302.2-3(C) (medical examination validity); 9 FAM 504.4-7 (medical examinations)
Why validity matters for the visa
The consular officer limits the immigrant visa to the medical exam’s validity, so an exam valid for four more months means a visa valid for four months. 9 FAM 504.4 says the exam is never valid for more than six months. An applicant who does not travel within that period needs a new exam unless the CDC has extended it, and if the TB part has expired, the whole exam is repeated.
Sources: 9 FAM 302.2-3(C) (medical examination validity); 9 FAM 504.4-7 (medical examinations)
What it costs
The exam is not a State Department or USCIS fee, and these official sources give no amount. 9 FAM 302.2-3(F)(1) says the post and the physician set fees for the exam, X-rays, vaccinations and blood tests based on prevailing local medical fees, and the price should not change during the panel physician’s agreement. Some physicians include vaccinations in the exam price, but vaccinations should not cost more than the physician charges the public. Ask the panel physician for the current price before booking. Civil surgeon fees in the United States are not covered by these official sources.
Sources: 9 FAM 302.2-6 and 302.2-3(F)(1)
Timing
These official sources do not say how long an exam appointment or the results take. The fixed periods are the validity windows above. Because the visa cannot outlast the exam, schedule it with the interview date and travel plans in mind, following the embassy’s instructions.
Family members
Each person immigrating has their own exam, children included. The exam’s validity limits each person’s visa separately, so a family whose exams fall on different dates can end up with visas that expire on different dates.
Sources: 22 CFR 42.66; 9 FAM 302.2-3(C) (medical examination validity)
Where cases commonly stall
- Booking a US doctor for a consular case. The visa medical has to be done by a panel physician abroad.
- Delaying travel after the visa is issued until the exam, and so the visa, has expired.
- Leaving Form I-693 out of an adjustment filing when it is required, which can lead USCIS to reject the I-485.
- Missing vaccination records. 9 FAM expects any missing required dose to be given before the visa, so bring the records you have.
Sources: 9 FAM 504.4-7 (medical examinations); 9 FAM 302.2-3(C) (medical examination validity); USCIS: Green Card for Immediate Relatives of U.S. Citizen; 9 FAM 302.2-6 and 302.2-3(F)(1)
How Visa Trouble can help
Free route discovery at Visa Trouble covers EB-1A and the National Interest Waiver alongside other green card paths. We’re building application preparation for both; it is planned, not open yet. We can point you to official information, but we don’t assess or prepare family-based green card applications. Visa Trouble is not a law firm and does not give legal advice.
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Official sources
Quoted from the official text as we captured it on 12 October 2026. Some links open the version we checked; look on the official site for any later change.
- INA 221(d), 8 U.S.C. 1201(d), Office of the Law Revision Counsel, US House of Representatives
“Prior to the issuance of an immigrant visa to any alien, the consular officer shall require such alien to submit to a physical and mental examination in accordance with such regulations as may be prescribed.”
- 22 CFR 42.66, Electronic Code of Federal Regulations
“The required examination shall be conducted in accordance with requirements and procedures established by the United States Public Health Service and by a physician selected by the alien from a panel of physicians approved by the consular officer.”
- 42 CFR 34.3(a), Electronic Code of Federal Regulations
“Documentation of having received vaccination against “vaccine-preventable diseases” for an alien who seeks admission as an immigrant, or who seeks adjustment of status to one lawfully admitted for permanent residence”
- 9 FAM 302.2-6 and 302.2-3(F)(1), US Department of State, Foreign Affairs Manual
“Applicants are required to receive at least one dose of each age-appropriate vaccine. If the applicant had previously received a dose or doses of a required vaccine but had not completed the series, then the next required dose should be administered.”
- 9 FAM 302.2-3(C) (medical examination validity), US Department of State, Foreign Affairs Manual
“Applicants not traveling to the United States within the exam validity period will need to undergo a new medical examination unless CDC has approved an extension of the original medical examination validity.”
- 9 FAM 504.4-7 (medical examinations), US Department of State, Foreign Affairs Manual
“The medical examination must be conducted by a panel physician who has been designated by the visa-issuing post to conduct medical examinations of applicants in the consular district in which the applicant applies for a visa.”
- USCIS Policy Manual, Volume 7, Part A, Chapter 6, Section D.1, US Citizenship and Immigration Services
“Adjustment applicants who must show they are not inadmissible on health-related grounds are typically required to undergo an immigration medical examination performed by a USCIS-designated civil surgeon in the United States.”
- USCIS: Green Card for Immediate Relatives of U.S. Citizen, US Citizenship and Immigration Services
“If you are required to submit a Form I-693 or partial Form I-693, you must submit it with your Form I-485. Otherwise, we may reject your Form I-485;”
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