Health & vaccination requirements

Who needs the immigration medical exam

The immigration medical examination is required for people seeking to become permanent residents (green card holders), whether through an immigrant visa processed abroad or through adjustment of status inside the United States. K visa (fiance) applicants also complete it. It establishes that the applicant is not inadmissible for health-related reasons.

Most nonimmigrant (temporary) visitors do not undergo this exam. However, a consular officer can require a medical exam in individual cases if there is reason to believe a health-related ground of inadmissibility may apply.

Panel physician vs civil surgeon

• Applying abroad (consular processing, Form DS-260): you must use a specific embassy-approved doctor known as a panel physician in the country where you interview. You cannot use your own family doctor.
• Applying inside the US (adjustment of status, Form I-485): you must use a USCIS-designated civil surgeon and the results are recorded on Form I-693.
• The exam typically covers a physical examination, a review of medical history, screening for certain communicable diseases (including tuberculosis testing), a drug/alcohol assessment and a mental-health assessment.
• For Form I-693, the civil surgeon must give you the completed, signed form in a sealed envelope; do not open it unless you are filing online and are instructed to upload it.

Vaccination requirements

US immigration law requires green card applicants to show they have received a set of vaccinations, or that a vaccine is not medically appropriate or not age-appropriate. The exact list is based on CDC criteria and is applied by the panel physician or civil surgeon.

Vaccines on the list have historically included tetanus and diphtheria toxoids, pertussis, polio, measles, mumps, rubella, rotavirus, Haemophilus influenzae type B (Hib), hepatitis A, hepatitis B, meningococcal, varicella, pneumococcal and influenza. Because the required list is periodically updated by the CDC, confirm the current requirements on the official vaccinations page before your exam.

• Only the examining physician can decide which listed vaccines are medically appropriate for you based on age, medical history and current condition.
• Waivers of the vaccination requirement may be available in limited situations, including on the physician's recommendation or on religious or moral grounds through a separate application.
• Bring any existing vaccination records to your appointment so the doctor can count doses you have already received.

Validity and timing

For consular (abroad) cases, complete the medical exam and any required vaccinations before your visa interview; the panel physician's report is time-sensitive and must be current at the time of visa issuance and travel, so schedule it close to your interview date.

For adjustment-of-status cases, a Form I-693 that was properly completed and signed by a civil surgeon on or after November 1, 2023 does not expire and can be used indefinitely as evidence. Because policy on validity has changed before, verify the current rule on the USCIS I-693 page.

Costs and practical notes

The medical exam and any vaccines are paid directly to the panel physician or civil surgeon and are separate from government filing fees such as the immigrant visa application fee or the Form I-485 fee (I-485 was $1,440 effective April 1, 2024). Exam and vaccine prices are set by the doctor and vary by country and clinic, so confirm the cost when you book.

Government fees change over time; check the official USCIS and Department of State fee pages for current amounts. Keep copies of your vaccination records and follow the exact submission method (mail vs online upload) required for your case.