Medical Exam Information

Instructions for the Medical Exam

If your medical exam report was not submitted with the initial adjustment of status filing, you will receive a “deficiency notice” in the mail stating that a completed and signed Form I-693 wasn’t submitted with your application. It looks like this:

Deficiency Notice

Don’t panic! It’s not a problem.  This notice is completely normal and expected. USCIS does not require that the immigration medical be submitted with the initial filing, and it can be hand-delivered at the time of the interview. Most of our clients present the medical at the time of  the interview.

Sometime in the next few months, please schedule your medical exam. Here are the steps:

    1. Find a USCIS-approved doctor. Visit this page, enter your ZIP code, and you will see a list of approved doctors for the medical appointment. Insurance is generally NOT accepted (you can ask when you schedule the exam). Please note that USCIS will NOT accept an exam from a doctor who is not on the list.
    2. Schedule an appointment and what to bring. Once you have a doctor’s appointment scheduled, you need to bring the following:
      • Government-issued photo identification, such as a valid passport or driver’s license.
      • Your vaccination or immunization record (such as DT, DTP, DTaP, Td, Tdap, OPV, IPV, MMR, Hib, hepatitis A, hepatitis B, varicella, pneumococcal influenza, rotavirus and meningococcal disease), if you have it. If you don’t have immunization records, that’s fine– you will need to get the immunizations during the appointment. If your records are in a language other than English you will need to have it translated or you’ll need to receive all the shots. If you believe that you have been immunized but do not have the records, the doctor should be able to do blood tests that can check for antibodies (immunity) against certain diseases. Additional fees may apply.
      • Proof of vaccination against COVID-19. As of October 1, 2021, all applicants for permanent residency are required to provide proof to the examining doctor that they have completed the COVID-19 vaccine series. Waivers (exceptions) are available for applicants who are too young to receive the vaccine, have a medical contraindication to the vaccine, or have a moral or religious objection to all vaccines. Note that a waiver based on a religious or moral objection will significantly delay the case (by at least a year, possibly more), and will likely cost thousands of dollars in government filing fees and additional attorney’s fees. Please bring it to our office’s attention immediately if you believe you may qualify for a vaccine waiver. 
      • Payment (usually between $500-600). Costs for the medical exams can vary significantly (we’ve heard reports of fees between $250 and $1500!) so you may want to call around and check fees before booking an appointment.
      • Most doctor’s offices will provide the Form I-693, Report of Medical Examination and Vaccination Record. However, if your doctor’s office requests that you print out the form and bring it to your exam appointment, it is available online here.
    3. Go to the exam at the scheduled time. The doctor will review your medical history with you, including prior hospitalizations, any chronic conditions, illnesses or disabilities, and history of psychiatric illness and/or harmful behavior. They will also test for communicable diseases such as tuberculosis, gonorrhea and syphilis. The tuberculosis test is now a blood test. The doctor will also check your records to see if you need any vaccinations. After the exam, the doctor will complete Form I-693 and seal the form in an envelope for you to submit to USCIS. Make sure you get a copy of the completed Form I-693 for your personal records before the doctor seals the envelope.
    4. Bring the sealed envelope from the doctor to your interview. USCIS will not accept the form if the envelope has been opened or altered. Or, if you’d prefer, you are welcome to mail the sealed envelope to our office and we can keep it safe in your file until your interview. Our mailing address is: Aloha Immigration, PO Box 26177, Honolulu, HI 96825.

You can find more information about the vaccination requirements here. And if you still have questions, feel free to reach out to us.