Bottom line: An immigration medical exam is the USCIS-required physical, testing and vaccination review that a designated civil surgeon records on Form I-693 for green card applicants in the United States. Lifecare Primary Medical in Richmond, TX has a USCIS-designated civil surgeon on staff who performs these exams and completes Form I-693. Most applicants must now file the completed I-693 together with Form I-485, so schedule early and call 281-712-7757 to confirm current fees.
Applicant guide
What is an immigration medical exam?
Most people applying for a green card (lawful permanent residence) from inside the United States must have a medical examination by a USCIS-designated civil surgeon. The civil surgeon records the results on Form I-693, Report of Immigration Medical Examination and Vaccination Record. The exam follows technical instructions from the CDC and confirms that applicants meet U.S. health requirements, including required tests and vaccines.
Lifecare Primary Medical has a USCIS-designated civil surgeon on staff who performs immigration medical exams and completes Form I-693 at 7103 South Peek Road, Suite 520, Richmond, TX 77407. Our clinic was recognized with a Best of 2026 BusinessRate award as an Immigration Physical Exam Medical Center in Richmond. Call 281-712-7757 to schedule and to confirm current fees.
What the exam includes
- Medical history and exam: a review of your medical history and a physical examination, following USCIS and CDC technical instructions
- Tuberculosis testing: an interferon-gamma release assay (IGRA) blood test for applicants 2 years and older, with a chest X-ray if the result is positive or other criteria apply
- Other required tests: screening for certain infections, as required for your age
- Vaccination review: a review of your vaccination records and any vaccines required for your age, or acceptable evidence of immunity
- Form I-693 completion: the completed form is provided as USCIS requires for submission with your application
2026 Form I-693 rules every applicant should know
| Rule | What it means for you |
|---|
| File it with your I-485 | Since December 2024, USCIS requires most adjustment-of-status applicants who need an exam to include Form I-693 when they file Form I-485. Filing without it can lead to rejection of the application. |
| Validity is tied to your application | Under June 2025 guidance, a Form I-693 signed on or after November 1, 2023 stays valid only while the application it was filed with is pending. If that application is withdrawn or denied, you need a new exam. |
| No 60-day signature window | USCIS removed the old rule requiring the civil surgeon to sign within 60 days before you file. |
| Only a civil surgeon can sign | For applicants in the United States, only a USCIS-designated civil surgeon can complete Form I-693. |
Immigration rules change. Always check the latest instructions on the USCIS Form I-693 page, and ask your attorney or accredited representative about your filing timeline.
What to bring and how the process works
- Call to schedule. Tell our staff about your filing deadline and any records you have, so we can explain fees and next steps.
- Gather documents. Bring a government-issued photo ID or passport, your vaccination records, translated into English if needed, a list of current medications, records for ongoing conditions, and any past tuberculosis tests, treatment or chest X-rays. Bring your eyeglasses or contact lenses, and the current edition of Form I-693 from the USCIS website if you have it.
- Exam and testing. The civil surgeon reviews your history, examines you and orders the required tests.
- Results and vaccines. Often a follow-up is needed once results are back or if additional vaccines are required. Timing depends on your tests and records.
- Form I-693 completed. Your completed form is provided as USCIS requires, ready to include with your application.
Missing vaccination records, fees and timing
Missing vaccination records? Bring any vaccination documentation you have, including records from another country. The civil surgeon reviews your age, documented vaccinations, medical history and acceptable evidence of immunity to determine what is needed under current CDC requirements. Missing paperwork does not automatically mean every vaccination must be repeated. Bring reliable English translations when your records are in another language.
Understand fees before your appointment. Fees vary with the tests and vaccines you need. When comparing immigration physical costs, ask what the quoted fee includes and whether laboratory testing, vaccinations, immunity testing and follow-up visits are included or charged separately. Call our office for current fees.
Allow time for results and paperwork. Your examination and the completion of Form I-693 may happen on different days. Tell the office if you have a filing deadline, and ask when completed paperwork is expected. Knowing whether testing and follow-up require separate visits helps you plan transportation and time away from work.
Language assistance. We offer services in English and Spanish. If you prefer another language, tell our staff when you call and ask whether assistance in your preferred language is available.
Other immigration-related medical forms
We can also help with Form N-648, Medical Certification for Disability Exceptions, for eligible naturalization applicants, and with medical evaluations required for some employment or visa applications abroad. Please call to describe what you need so our staff can confirm before your visit. Our clinic sees adults 18 and older, so call to ask about exams for younger family members. For routine checkups after your immigration process, see our annual physicals and preventive care, or contact us with questions.
