Immigration Physicals & I-693 Medical Exams

I-693 USCIS medical exams by an authorized civil surgeon — vaccinations, lab work, and sealed paperwork for green card applicants.

Dr. Efraim Kessous is a USCIS-designated civil surgeon authorized to perform immigration medical examinations and complete Form I-693 for green card applicants.

What Is an Immigration Physical?

If you are applying for a green card (lawful permanent resident status), USCIS requires a medical examination documented on Form I-693 — the Report of Medical Examination and Vaccination Record. This form must be completed and signed by a USCIS-designated civil surgeon.

Purpose of the Exam

  • Screen for communicable diseases (TB, syphilis, gonorrhea)
  • Verify vaccination records per CDC technical instructions
  • Assess physical and mental health conditions
  • Document findings on Form I-693 for USCIS review

Who Needs This Exam?

  • Applicants filing Form I-485 (Adjustment of Status)
  • Green card applicants through family sponsorship
  • Green card applicants through employment
  • Applicants adjusting status through other categories (asylum, diversity visa, etc.)

Dr. Kessous Is a USCIS-Authorized Civil Surgeon

Dr. Efraim Kessous is listed in the official USCIS civil surgeon directory and is fully authorized to conduct I-693 medical examinations in Maryland. All exams follow the latest CDC and USCIS protocols.

What to Bring to Your Immigration Physical

Come prepared with the following to ensure a smooth appointment and timely I-693 processing.

Government Photo ID

Passport, driver's license, or state ID

Vaccination Records

Translated to English if needed

Current Medications List

Names, dosages, and reasons

Prior TB / STI Records

Any previous test results

Additional Items (If Applicable)

  • USCIS appointment letter or instructions referencing Form I-693
  • Form I-693 with Part 1 completed (blank copies available at our office)
  • For applicants under 14: Proof of identity with full name, date and place of birth, and parent information (e.g., birth certificate)

The Exam Process — What to Expect

The immigration physical typically requires two visits. We complete all lab work on your first visit so results are ready when you return.

1

First Visit — Lab Work & Records Review

  • TB screening — blood test (IGRA) for most patients; skin test (TST) for children under 2
  • Syphilis blood test — required for ages 15 and older
  • Gonorrhea urine test — required for ages 15 and older
  • Vaccination record review — we identify which vaccines are needed
  • Medical history review — comprehensive health evaluation
2

Second Visit — Physical Exam & I-693

  • Complete physical examination by Dr. Kessous (civil surgeon)
  • Lab results review — all test results reviewed and documented
  • Required vaccinations administered if needed
  • Form I-693 completed, signed, and sealed in a tamper-proof envelope
  • Personal copy provided for your records

Bring Form I-693 to your second visit with Part 1 completed. Do not sign it until Dr. Kessous instructs you to do so. Blank copies are available at our office if you don't have one.

Required Vaccinations for Immigration

USCIS requires applicants to be vaccinated against certain diseases per CDC technical instructions. If your vaccination records show you've already received them, you will not need to repeat them. If records are unavailable or incomplete, we can administer the required vaccines during your visit.

Vaccine Required For Notes
MMR (Measles, Mumps, Rubella) All applicants born after 1957 2 doses required; or lab-confirmed immunity
Hepatitis B All applicants 3-dose series; or lab-confirmed immunity
Varicella (Chickenpox) All applicants 2 doses; or lab-confirmed immunity; or documented history of disease
Tdap (Tetanus, Diphtheria, Pertussis) All applicants age 2+ 1 dose Tdap; plus Td booster every 10 years
Influenza (Flu) All applicants age 6 months+ Required during flu season (October–March)
COVID-19 All applicants age 6 months+ Per current CDC recommendations
Pneumococcal Ages 2–4 and 65+ Age-appropriate series
Polio (IPV) Ages 2 months – 17 years 4-dose series
Rotavirus Infants 6 weeks – 8 months 2 or 3 dose series depending on brand
Hib (Haemophilus influenzae type b) Ages 2 months – 4 years Age-appropriate series
Hepatitis A Ages 12 months – 23 months 2-dose series

Requirements are age-dependent and may change. See the CDC Vaccination Technical Instructions for full details.

Bring Your Vaccination Records

Having your vaccination records can help avoid unnecessary repeat vaccinations and reduce costs. If your records are in a language other than English, they must be translated by a professional translator. We can help arrange translation if needed.

After the Exam — Turnaround & Next Steps

Once your exam is complete, here's what to expect for receiving and submitting your I-693 paperwork.

1–2 Week Processing

If all test results come back normal, expect a call within 1–2 weeks to let you know the paperwork is ready to collect.

Sealed & Signed

Your Form I-693 will be completed, signed, and sealed in a tamper-proof envelope. You'll receive a personal copy for your records.

Do Not Open

USCIS will not accept Form I-693 if the sealed envelope is opened, altered, or the seal is broken in any way.

Submitting to USCIS

Submit the sealed I-693 envelope to USCIS along with your Form I-485 (Application to Register Permanent Residence or Adjust Status). Form I-693 is valid for 2 years from the date the civil surgeon signs it. If your results require further evaluation or treatment, we will contact you with next steps before completing the form.

Frequently Asked Questions

Common questions about immigration physicals and Form I-693.

What is a Form I-693 immigration physical?

Form I-693 is the Report of Medical Examination and Vaccination Record required by USCIS for green card (adjustment of status) applicants.

It must be completed by a USCIS-designated civil surgeon. Dr. Efraim Kessous at Montgomery Medical Clinic is an authorized civil surgeon listed in the USCIS directory and fully qualified to perform these exams.

What does the immigration physical include?

The exam includes:

  • Complete physical examination by a civil surgeon
  • Review of vaccination records against CDC requirements
  • Tuberculosis (TB) blood test (IGRA)
  • Syphilis blood test (ages 15+)
  • Gonorrhea urine test (ages 15+)
  • Any vaccinations needed to meet USCIS requirements

We complete all lab work during your first visit so results are ready for the physical exam on your second visit.

How many visits does the immigration physical require?

The process typically requires two visits:

  • First visit: All lab work (blood tests, TB screening, urine tests) and vaccination records review
  • Second visit: Physical examination, results review, vaccinations if needed, and completion of Form I-693
How long does it take to get the I-693 paperwork back?

If all test results come back normal, you can typically expect a call within 1–2 weeks to let you know the paperwork is ready to collect.

Results that require additional follow-up or treatment may take longer. We will contact you promptly with next steps if this is the case.

What should I bring to my immigration physical?

Please bring the following:

  • Valid government-issued photo ID (passport, driver's license, or state ID)
  • Vaccination records (translated into English if needed)
  • List of current medications with dosages
  • Any previous TB test or STI screening results
  • USCIS appointment letter or I-693 instructions (if applicable)

Having complete vaccination records can help avoid unnecessary repeat vaccinations and reduce costs.

Can I open the sealed I-693 envelope?

No. USCIS will not accept Form I-693 if the envelope is opened, altered, or the seal is broken in any way. You will receive a personal copy of your results for your records, but the official sealed envelope must be submitted intact with your I-485 application.

Does insurance cover the immigration physical?

Immigration physicals are generally not covered by insurance, as they are classified as regulatory screening exams. Rates vary by civil surgeon. USCIS does not regulate fees.

Montgomery Medical Clinic offers competitive self-pay pricing. Call (301) 208-2273 for current pricing information.

How long is the I-693 valid?

Form I-693 is valid for 2 years from the date the civil surgeon signs it. USCIS must receive the form within this window. If the form expires before your case is adjudicated, you may need to undergo a new medical examination.

What if my exam reveals a medical problem?

If your exam reveals a medical condition that could affect your admissibility — such as a communicable disease — you may be asked to provide additional documentation or undergo further evaluation. Some conditions may require treatment before the I-693 can be completed.

In certain cases, you may be eligible to apply for a waiver of inadmissibility. Dr. Kessous will explain your options and help guide you through the process.

Ready to Schedule Your Immigration Physical?

Contact us to book your USCIS immigration medical examination with Dr. Kessous.