Process & Requirements

Filling out the I-693 Form

You may get a head start by printing and filling out Form I-693 (Report of Medical Examination and Vaccination Record), and bringing it in with you to your appointment. Fill out the first section but DO NOT SIGN until instructed to do so.

Instructions for filling out the I-693 Form can be read by clicking here.

What to bring with you to the immigration exam or immigration physical

  • Valid, government issued picture ID such as a driver’s license or passport.

  • Immigration Physical Form I-693, with the top of page 1 completed with your information. DO NOT SIGN until instructed to do so.

  • If available, proof of prior vaccinations and positive TB (tuberculosis) test or PPD – we do not accept TB tests from other providers unless they are positive

The Exam

The full INS immigration exam is very simple and requires only 4 basic steps and one to two office visits, depending on what you have had done before, and on your age:

1.  Basic immigration physical exam and mental status evaluation.

2. Tuberculosis Screening

  • PPD screen is included in the fee, will require return appointment to the clinic between 48 and 72 hours after placement for reading
  • Quantiferon Gold blood test is available as an alternative to the PPD skin test for an additional fee of $75. This is a more sensitive test that does not require returning to the clinic for results
  • Should the screening be positive, a chest x-ray to rule out positive TB will be required and may incur an additional charge
  • If you have official documentation of a positive TB screening results. Please bring this documentation to your initial appointment

3. Infectious Disease Screening Tests

  • Syphilis
  • Gonorrhea

4. Lab/Documentation Review of Vaccines and Necessary Additional Medical Paperwork

Vaccine Requirements by Age

Required Offical Lab Screening Tests or Documentation of Vaccines (series if applicable) to Confirm Immunity of:

  • MMR – Documentation of vaccine series or proof of immunity acceptable
    • Required for patients 1 year through 59 years of age at the time of the physical exam
  • Varicella – Documentation of vaccine series, immunity or history of disease acceptable
    • Required for patients 1 year of age and up at the time of the physical exam
  • TD/TDAP – Documentation of booster vaccine within 10 years of application submission to USCIS is required
    • Required for all applicants 6 months of age and older
  • The following are required for certain age groups and medical conditions and must show series up-to-date for age or in progress and without sufficient time interval for next dose at the time of the physical exam
    • Rotavirus: 6 weeks to 8 months
    • HiB: 2 months – 59 months
    • HAV: 12 months – 23 months
    • HBV: 0 months – 19 years
    • Pneumonia: 2 months – 59 months & 65 years and older
    • DTP/DTaP/DT: 2 months – 7 years
    • OPV/IPV: 2 months – 19 years
    • MCV: 11 years – 19 years

You may choose to have some of the required tests/immunizations done by your own doctor or provider. Please provide your physician with this list in order to ensure completeness. Please note that the examination and I-693 paperwork can only be performed by a licensed civil surgeon. If you will have tests/immunizations done outside of Roots, it is your responsibility to provide us with proof of these examinations.

Vaccines may need to be purchased at alternative pharmacies or providers if labs show insufficient immunity or are necessary according to CDC guidelines.

Health History

If you have a known chronic disease you will need to bring documentation proving control and/or current treatment of the condition and a medication list if applicable

  • Examples of chronic conditions include but are not limited to:
    • High blood pressure & other cardiovascular diseases, diabetes, lung disease, as well as any mental health and/or substance abuse conditions
  • Examples of documentation proving control or treatment can include:
    • Lab tests and/or treatment notes
    • Attestation from PCP stating ongoing treatment and control of the condition

Religious and/or Moral Beliefs

If religious or moral beliefs stop an applicant from receiving any or all of the required vaccines according to CDC guidelines, the applicant is responsible for reviewing the USCIS guidelines for this blanket waiver and the clinic is not responsible for any delay or rejection of the application that may come about as a consequence of this decision or belief.

Review the requirements for the blanket waiver by clicking here

After the Exam

After the immigration physical examination is completed, the doctor will certify Form I-693 with the test results of the immigration exam and vaccination history in a sealed enveloped to present to the INS or your attorney. DO NOT OPEN THE SEALED ENVELOPE. Turn in the envelope with your immigration application. A copy of your immigration form will be provided for you to keep after results have been discussed with the examining doctor. The examination will only be valid up to a year after the immigration exam date. Click here to visit the Official US Citizen & Immigration Services website for more information.

Disclaimer: It is the responsibility of the applicant to submit any and all valid labs/documentation that have not been completed or processed through Roots Community Health Center. The civil surgeon may need up to 2 weeks after all requirements are completed to finish the packet and give back to the applicant.

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