How to Prepare for Adjustment of Status Medical Exam

The adjustment of status medical exam is a mandatory step that can make or break your immigration case. USCIS requires specific tests and vaccinations from approved civil surgeons.

We at Law Offices of Jeffrey A. Thompson see applicants struggle with this process daily. Poor preparation leads to delays, additional costs, and sometimes case denials.

What Medical Tests Are Required for Your Green Card Application

USCIS mandates specific medical tests that every adjustment of status applicant must complete. The immigration medical examination includes tuberculosis tests that use the interferon gamma release assay for applicants aged 2 and older, plus blood and urine tests for syphilis and gonorrhea for those 15 and older. A chest X-ray is required regardless of age, and pregnant women must still complete this test with proper safety precautions.

Required Vaccinations for Immigration Status

Civil surgeons must verify your vaccination status against CDC requirements. Required vaccines include Hepatitis A, Hepatitis B, Measles, and Tetanus (among others). If you lack vaccination records, the panel physician will help determine which vaccines you need.

You can request waivers for vaccination requirements if legitimate medical reasons exist, based on the panel physician’s recommendation.

How Civil Surgeons Conduct Your Medical Exam

Only civil surgeons that USCIS designates can perform your medical examination. The average cost ranges from $200 to $490, with UC San Diego Health that charges $490 for their comprehensive exam (includes basic lab tests). Use the USCIS Find a Doctor tool to locate certified civil surgeons in your area. These doctors must follow CDC guidelines and register for the eMedical electronic health processing system.

Documents You Must Bring to Your Appointment

Bring your passport, complete vaccination records, current medication list, and an unsigned Form I-693 to your appointment. Medical history documentation proves vital if you have previous tuberculosis treatments, mental health conditions, or substance abuse history. The civil surgeon will complete Form I-693 and seal it in an envelope. Never open this envelope yourself, as USCIS will reject opened or altered forms.

Timeline and Submission Requirements

Schedule your appointment at least 6-8 weeks before you file Form I-485, as medical results remain valid for only six months. As of December 2, 2024, you must submit Form I-693 simultaneously with Form I-485 to avoid automatic rejection of your green card application. This new requirement eliminates delays that previously occurred when applicants submitted forms separately.

Once you understand these requirements and gather your documents, you need to prepare mentally and physically for what happens during the actual examination process.

How Should You Prepare for Your Medical Examination

Start Medical Record Collection 30 Days Before Your Appointment

Contact your primary care physician, specialists, and previous healthcare providers immediately to request complete medical records. Most medical offices require 7-14 business days to compile records, and some charge $25-50 for copy fees. Request vaccination records from your childhood doctor, school health offices, and any military service records if applicable. The CDC requires documentation for 14 specific vaccines, and absent records force you to repeat vaccinations unnecessarily. Create a chronological timeline of your medical history that includes surgeries, hospitalizations, and treatments with exact dates and healthcare provider names.

Physical Examination Components and Mental Health Assessment

The civil surgeon will conduct a standard physical examination that includes height, weight, blood pressure, and visual inspection for signs of communicable diseases or mental disorders. Mental health evaluation focuses on harmful behavior patterns, not general anxiety or depression. Civil surgeons specifically look for conditions that pose public safety risks according to Immigration and Nationality Act Section 212. Applicants with previous psychiatric treatment must bring written certification from their physician that documents current mental status and medication compliance. The examination takes 45-90 minutes (time varies based on your medical complexity and required follow-up tests).

Medical Conditions That Require Additional Documentation

Tuberculosis history demands the most preparation time, as you need treatment completion certificates and chest X-ray comparisons that span multiple years. Substance abuse history requires documented rehabilitation completion and proof of sobriety maintenance. Chronic conditions like diabetes, heart disease, or autoimmune disorders need current treatment plans and medication lists from your specialists. Pregnancy requires special handling for chest X-rays, but civil surgeons cannot defer the examination. Previous positive tuberculosis skin tests trigger additional QuantiFERON blood tests and potential treatment requirements that can delay your adjustment of status by 3-6 months.

Understanding these preparation steps helps you avoid delays, but the financial aspect of your medical exam requires careful planning to budget appropriately for all components and timeline considerations.

What Does the Immigration Medical Exam Cost

Medical Exam Fee Structure

Immigration medical exams cost between $200 and $490 at most civil surgeon offices. UC San Diego Health charges $490 for their comprehensive package that includes basic lab tests and vaccine recommendations.

The basic immigration medical exam costs $435 and includes blood work for syphilis, chlamydia, and gonorrhea, plus a physical exam and follow-up. Required vaccinations range from $25-75 per shot, and absent vaccination records can force you to pay for complete vaccine series that cost $300-500 total. Chest X-rays add $75-125 to your bill, and pregnant women pay the same amount despite special safety precautions.

Location and Practice Variables

Civil surgeons operate as independent contractors, so prices vary significantly by location and practice overhead costs. Urban areas typically charge higher fees than rural locations due to increased operational expenses. Some practices offer package deals that bundle all required tests, while others charge separately for each component. Payment policies differ between offices – most require full payment at the time of service, though some accept payment plans for higher-cost examinations.

Medical Exam Timeline Requirements

Medical exam results remain valid for six months from completion date, but applicants with Class A medical conditions (like active tuberculosis) get only three months of validity. Schedule your appointment 6-8 weeks before you file Form I-485 to allow time for any follow-up treatments or additional tests. Civil surgeons typically complete Form I-693 within 2-3 business days after your appointment, but tuberculosis treatment delays can extend this timeline to 3-6 months.

Appointment Availability Factors

Most civil surgeon offices book appointments 2-4 weeks in advance during peak immigration seasons. The December 2024 simultaneous submission requirement means you cannot file Form I-485 without your sealed medical envelope, which makes appointment timing absolutely critical for your green card timeline. Early appointment scheduling prevents costly delays and gives you buffer time to address any unexpected medical issues that could affect your adjustment of status application.

Final Thoughts

Your adjustment of status medical exam success depends on thorough preparation that starts 30 days before your appointment. Collect complete medical records, vaccination histories, and treatment documentation to avoid delays that cost time and money. Schedule your civil surgeon appointment 6-8 weeks before you file Form I-485, as the December 2024 simultaneous submission requirement means you cannot proceed without your sealed medical envelope.

Proper preparation accelerates your immigration case and prevents Requests for Evidence that add 3-6 months to processing times. Complete vaccination records eliminate unnecessary repeat shots, while organized medical histories help civil surgeons complete Form I-693 efficiently. Budget $200-490 for the exam plus additional costs for missing vaccinations or follow-up treatments (if required).

After you complete your medical requirements, file Form I-485 and Form I-693 simultaneously to avoid automatic rejection. Keep copies of all documents and maintain your sealed medical envelope until submission. We at Law Offices of Jeffrey A. Thompson help clients navigate complex immigration processes and provide expert guidance from paperwork preparation through legal challenges.