An immigration physical, or “green card exam” is a requirement of the U.S. Citizen and Immigration Services (USCIS) for people who want to become residents of the United States. The Centers for Disease Control and Prevention (CDC) issues detailed guidelines for immigration physicals, the doctors that perform them, and the patients being examined. The main aim of these guidelines is to uphold the Immigration and Nationality Act (1952) regulations which can confirm or deny admissibility to the United States on health grounds.(1)
The primary aims of an immigration physical are to:
- Ensure persons entering the United States are healthy individuals who do not have certain contagious diseases.
- Check vaccination status, and issue the necessary vaccinations should they be required.
- Identify any other conditions such as a physical or mental disorder that causes harmful behavior, or drug abuse.
At Dr. G’s Urgent Care, we offer comprehensive immigration physical services. We have locations throughout South Florida, with offices in Delray Beach, Lake Worth, Coral Springs, Fort Lauderdale, and Deerfield Beach. To find out more, please fill out our online contact form, or call us directly at (561) 330-9363. If you need to send us any documentation pertaining to your immigration physical, our fax number is (561) 274-1930.
- 1 Combating Communicable Disease
- 2 Vaccination Requirements
- 3 Scheduling Your Physical
- 4 Before your Examination
- 5 What Happens at an Immigration Physical?
- 6 What Happens After the Immigration Physical?
- 7 Cost of an Immigration Physical in South Florida
- 8 FAQ
- 9 References
Combating Communicable Disease
Outbreaks of diseases in any community pose risks to everyone. Viruses and bacteria spread through contact with contaminated surfaces, insect bites, bodily fluids and blood, or through the air.(2) Public health initiatives lower the risk of contagious diseases from spreading, and are an important part of the immigration process. To ensure public safety, it is critical to test for harmful contagious diseases. Therefore, immigration physicals screen for diseases that can affect public health. There are two main communicable disease classifications:
- Quarantinable Diseases: A quarantinable disease requires a period of isolation to prevent further spread. Current CDC-recognized diseases in this category include: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers (such as Ebola), severe acute respiratory syndromes, influenza, and measles.
- PHEIC: Public Health Emergencies of International Concern (PHEIC) are designated by the World Health Organization (WHO). These are extraordinary events deemed to pose a substantial risk to all, and currently include: COVID-19, polio, smallpox, SARS, and pandemic influenza.
Depending on your age, you are required to be vaccinated against the following diseases as part of your medical examination for immigration purposes: (1)
- Tetanus and diphtheria toxoids
- Pertussis (whooping cough)
- Haemophilus influenzae type B
- Hepatitis A
- Hepatitis B
- Meningococcal Disease
- Varicella (chicken pox)
- Pneumococcal pneumonia
With the exception of the COVID-19 series, only a single dose of each vaccine is required for immigration purposes. Patients who do not complete the series will be counseled to ensure they return for their next vaccine doses to complete the series.
Scheduling Your Physical
The immigration process can be long, drawn-out, and complicated. That’s why it’s important to be proactive with your application and prepare ahead of time, especially when it comes to arranging your physical examination. We advise applicants to plan for their appointment with us before they start their application. That way, you can submit all of your medical details alongside the necessary government forms and supporting documents in your application package. Though “concurrent filing” isn’t a requirement, it’s an efficient way to get all of the relevant information to USCIS at the same time!
Please read the instructions on the USCIS website carefully before you begin your application so you know which documents you need to provide in your application packet. Contact Dr. G’s at (561) 330-9363 to schedule your immigration physical or dial (561) 274-1930 to fax medical documentation to us.
Before your Examination
There are a few important things you must do when you come to see us for your immigration physical. Please bring the following items with you:
- A form of government-issued identification such as your passport, state ID, drivers license, work permit, or travel permit (expired identification documents are not accepted)
- Proof of your prior vaccination and immunization history
- A completed I-693 form (available as a PDF download on the USCIS website)
- The required fee (varies according to applicant)
- A list of your current medications
- Any other relevant immigration documentation advised
What Happens at an Immigration Physical?
If you’re nervous about your immigration physical, please don’t worry! The procedure is straightforward, and we’re here to help. We’ll explain each step of the process for your peace of mind. We’ll also be happy to answer any questions you have before, during, and after the examination. To help you get an idea of what to expect, here are a few details about the process.
The doctor will ask you to provide details of your medical history. She will inquire about any chronic physical or mental conditions, whether these required hospitalization, and if these conditions caused “a substantial departure from a normal state of well-being or level of functioning.”(3)
Vaccination, Immunization & Tuberculosis
At your immigration physical you will be asked to provide your vaccination history. You will also undergo testing for the infectious lung disease tuberculosis (TB). The doctor will perform a blood test called an Interferon Gamma Release Assay (IGRA) test. All applicants over the age of 2 years must undergo IGRA screening.(4) If you have previously received TB immunization, or any other immunizations or vaccinations, please provide the relevant documentation at or before your appointment. Certain patients may require further testing and a chest x-ray to determine their TB status.
USCIS provides details of the current medically appropriate vaccinations by age on their website. Be sure to stay up-to-date and check their website regularly for updates prior to your appointment with us.
If we do not receive your immunization history, or if it is unavailable, we will conduct a blood titer test. This test screens for any immunity from specific diseases by checking the concentrations of certain antibodies in your blood. Depending on your circumstances, further vaccinations may be required, and may be administered at this point.
The doctor will then proceed with your physical examination. They will typically assess the following areas of the body:
- Nose and Throat
- Arms and Legs
- Lymph Nodes
- External Genitalia
After your physical examination, the doctor will perform a mental evaluation. They will typically assess the following areas:
USCIS regulations stipulate that applicants with physical or mental disorders that cause harmful behavior will be denied residency status in the United States. (4)
What Happens After the Immigration Physical?
After your examination is complete, Dr. Graber will sign your completed I-693 form and return it to you in a sealed envelope.
Important Notice: Do NOT, under any circumstances, attempt to open this envelope, or tamper with the seal. This envelope may only be opened by USCIS personnel.
Depending on your individual circumstances, you may be asked to submit further documentation (such as I-485, Application to Adjust Status). If you have already completed and submitted this paperwork, you may submit your sealed envelope to an immigration official at your green card interview with USCIS.
Please note: Immigration physical results are usually valid for two years.
Cost of an Immigration Physical in South Florida
How long is an immigration physical?
You should expect most immigration physical examinations to last between 1-2 hours, so be sure to set aside the necessary time in your day. The length of your examination will depend on your individual circumstances, and how many tests are required.
How many appointments do I need to make for an immigration physical?
The number of appointments you need for an immigration physical will depend on your circumstances, and the policies of the doctor you visit. Some doctors complete their testing in one session, while others will require a follow-up visit. Please inquire about the number of appointments required by your provider when you schedule your appointment.
What is an IGRA test?
Interferon Gamma Release Assay (IGRA) tests are whole blood tests that screen for infectious diseases such as tuberculosis. An IGRA test measures the release of a molecule called gamma interferon by white blood cells in a sample of blood. Persons over the age of 2 years who apply for U.S. residency are required to complete IGRA screening as part of their immigration physical examination.
Are there different protocols for children during the immigration physical?
All immigrants wishing to obtain U.S. residency must undergo a physical, including children. However, individuals under 15 are not required to undergo chest x-rays or blood tests. Speak to your provider to obtain further details regarding the specifics of inmmigration examinations for youth under 15.
I have a disability. What will happen during my immigration examination?
USCIS requires individuals with disabilities to complete Form N-648, Medical Certification for Disability Exceptions. For further details about their requirements, please see the USCIS website.
- Medical Examination: Frequently Asked Questions (FAQs) | Immigrant and Refugee Health | CDC. (2021, March 12). Www.cdc.gov. https://www.cdc.gov/immigrantrefugeehealth/about/medical-exam-FAQs.html
- Edemekong, P. F., & Huang, B. (2019, August 10). Epidemiology Of Prevention Of Communicable Diseases. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470303/
- Medical History and Physical Examination Technical Instructions for Civil Surgeons | CDC. (2019, November 6). Www.cdc.gov. https://www.cdc.gov/immigrantrefugeehealth/civil-surgeons/medical-history-and-physical-exam.html
Chapter 7 – Physical or Mental Disorder with Associated Harmful Behavior | USCIS. (2019, December 10). Www.uscis.gov. https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-7