Immigration Medical Exam

Foundations Direct Care provides immigration medical exams conducted by a civil surgeon, a doctor designated by U.S. Citizenship and Immigration Services (USCIS) to perform immigration physicals and sign the required form. We offer immigration physicals to children older than 2 months and adults of all ages.

Foundations Direct Care makes immigration medical exams quick in 5 easy steps!

Step 1: Schedule your Appointment

Foundations DPC is a USCIS-designated civil surgeon that can perform the medical examination required for the I-693 form. 

Make an Appointment: Contact our office to schedule your appointment. It's a good idea to schedule your examination as close as possible to the time you plan to submit your Form I-485, Application to Register Permanent Residence or Adjust Status, to ensure that the medical examination results are still valid at the time of USCIS review.  

Step 2: Prepare the Necessary Documents

Before you arrive, make sure you prepare the following documents.

  1. Government-issued Photo Identification: Bring a valid, government-issued photo ID, such as a passport or driver's license.
  2. Vaccination Records: Bring your vaccination records to show which vaccines you've already received. This can help avoid unnecessary vaccinations.
  3. Medical Records: Bring records of any chronic or serious medical conditions and treatments, including hospitalization records.
  4. Form I-693: Download and fill out the first part of Form I-693 from the USCIS website before your appointment. Leave the parts to be completed by the civil surgeon blank.
Step 3: Foundations Medical Examination

When you arrive for your first visit, you will undergo a 45-60 minute medical evaluation covering the following areas.  

  1. Physical and Mental Examination: A Foundations Direct Care doctor will perform a comprehensive physical and mental health examination.
  2. Laboratory Tests: You will undergo required tests for communicable diseases such as tuberculosis, syphilis, and gonorrhea.
  3. Vaccinations: Foundations Direct Care provider will review your vaccination records and administer any required vaccines that you have not yet received.
Step 4: Review and Sign the Form I-693

After completing the medical examination and any necessary vaccinations, A Foundations Direct Care provider will fill out Form I-693. You will need to review the form to ensure that all the information is correct and then sign it in the presence of the Foundations Direct Care provider.

Step 5: Receive the Sealed Envelope
  1. Sealed Envelope: Foundations Direct Care will seal the completed Form I-693 and any supporting documentation in an envelope. You must not open this envelope. Opening the envelope will invalidate the form.
  2. Submission to USCIS: Submit the sealed envelope with your Form I-485 application to USCIS. Remember, the medical examination report is valid for a specific period (usually two years from the date of the examination), so plan your submission accordingly.


  • Why are these medical exams needed?

    When applying for lawful permanent residence from within the United States, applicants may be required to meet the public health grounds of inadmissibility outlined in section 212(a)(1) of the Immigration and Nationality Act (INA).

    Therefore, most green card applicants filing Form I-485 will also need to file Form I-693 in order to meet the public health criteria, which are as follows.

    U.S. Immigration Medical Exam Public Health Criteria

    • A civil surgeon authorized by U.S. Citizenship and Immigration Services (USCIS) must examine the applicant, following U.S. Department of Health and Human Services (HHS) regulations.
    • Form I-693 must be completed by the applicant and civil surgeon.
    • Form I-693 must be signed by the civil surgeon within two years of filing Form I-485.
    • Form I-693 must show that the applicant has received the required vaccinations (including the COVID-19 vaccine).
    • Form I-693 must show that the applicant does not have a Class A medical condition (see below).
    • USCIS must make a decision within 2 years of the civil surgeon signing Form I-693.

    Failure to satisfy these public health criteria could result in a Request for Evidence (RFE) or an outright denial of the green card application. Certain green card applicants — such as those adjusting status from the K-1 visa — will not be required to undergo a medical exam, as they have already been examined prior to entering the United States.

    A Class A medical condition is defined as follows:

    • A communicable disease deemed significant by HHS, including:
      • Gonorrhea
      • Hansen’s disease
      • Syphilis
      • Tuberculosis
    • A lack of vaccines for preventable diseases
    • A “physical or mental disorder” which may result in dangerous behavior
    • Addiction to drugs
  • What is the I-493 Form?

    Anyone applying for a green card from within the United States will need to prove that they are not inadmissible on public health grounds. To do this, applicants will need to file Form I-693 (officially called “Report of Medical Examination and Vaccination Record”).

  • How are the I-693 and the I-493 Forms related?

    Form I-693 should be signed by an authorized civil surgeon no more than two years prior to filing Form I-485 (officially called “Application to Register Permanent Residence or Adjust Status”).

    Generally speaking, Form I-693 is filed together with I-485. The processing time of I-485 can vary greatly — anywhere from 6 months to 4 years — depending on the circumstances.

  • What to Bring to Your USCIS Exam

    Please bring the following to your appointment:

    • Your passport from your country of origin
    • Proof of your vaccination record
    • A list of medications you currently take
    • Your completed I-693 form. Do not sign your I-693 form. It needs to be signed in the presence of your doctor.
  • How much does the Immigration Physicals cost?

    The cost of an immigration physical is $325 for adults and $300 for childen including TB testing.  This does not include basic labs and vaccine recommendations.  Imaging or treatment for an infectious disease are not included with the medical exam.  Foundations Direct Care does not accept insurance payments for the medical costs, vaccines, or the laboratory tests.

  • What are some common issues that arise during the Immigration Medical Exam?

    There are a few ways that fail your medical examination:

    • If you don't provide documentation for the required vaccinations or obtain a waiver for them 
    • If you test positive for tuberculosis, gonorrhea or syphilis and don't provide documentation of follow-up testing or treatment to USCIS
    • If you have a physical or mental health condition that requires a follow-up by the health department or referral evaluation and you don't provide follow-up details to USCIS

Medical Exam


(children under 15 = $300)


$50 - $200

discounted rate

Laboratory Tests


 (syphilis $15, gonorrhea $40)