Immigration physical (Form I-693) in Anaheim

Civil surgeons follow CDC's Technical Instructions, which set the age ranges in the table above. A few details matter:

• TB means a blood test. From age 2, CDC requires an IGRA such as T-Spot or TB Gold. The skin test is only an option for children under 2.
• Chest x-ray: needed after a positive TB blood test, and for anyone with known HIV or TB symptoms whatever the blood test shows. The clinic takes x-rays on site.
• Outside the age ranges, the civil surgeon can still test for syphilis or gonorrhea when there is reason to suspect an infection.
• Follow-up: an x-ray that suggests active TB means a referral to the local health department, and the form cannot be signed until that is done.

Tested positive for TB before? Bring the written result. CDC accepts a documented earlier positive TB blood test that shows the date, test type, result and the doctor's details, and a chest x-ray follows. For a TB test for work or school instead of USCIS, see TB tests and flu shots.

USCIS requires proof of the vaccines on CDC's list for your age. A dose on an acceptable written record counts, so you do not pay to get it again.

• Bring every record you have: childhood cards, school or home-country records, pharmacy printouts, with English translations. Each dose needs a month, day and year; doses you remember but cannot show on paper do not count.
• Do not get shots on your own first. USCIS asks applicants to wait for the civil surgeon's review, in case a vaccine is not medically appropriate for them.
• No record? For measles, mumps, rubella, hepatitis A and B, polio and chickenpox, a blood test proving immunity is accepted instead of the shot (ask its price first). A verified past chickenpox illness can also count.
• Your own doctor may give missing vaccines after the evaluation; bring those records back for the civil surgeon to note.
• Blanket waivers cover a vaccine that is wrong for your age or health, or flu vaccine when none is available. The civil surgeon marks them; you do not apply.

• Government photo ID, such as an unexpired passport or driver's license. Children under 14 can bring a birth certificate (translated if needed).
• Form I-693 from uscis.gov/i-693 with Part 1 filled in. Do not sign it yet: you sign in front of the civil surgeon.
• All vaccination records.
• A copy of your medical history, plus any earlier TB results or chest x-ray reports.
• Your insurance card, if you have one, and payment, which the clinic collects at the visit (cash, check or card).

1. The civil surgeon checks your ID, and you sign Part 2 of the form in front of them.
2. The civil surgeon goes over your history, including medicines, mental health and any drug or alcohol use, because the USCIS form asks about each.
3. A physical exam, then the blood draw and urine sample your age calls for.
4. A vaccine review, with missing shots given or planned.
5. When every result is back and any follow-up is complete, the civil surgeon signs the form and seals it.

If you mail your I-485, no. The civil surgeon seals the original form in an envelope marked "DO NOT OPEN. FOR USCIS USE ONLY," initials across the flap and tapes over it. USCIS will not accept a Form I-693 from an envelope that has been opened or altered. Read your results on the extra copy included in the $200 fee instead.

If you file your I-485 online, the rule is different: USCIS tells online filers to open the envelope and upload the completed form, then keep the original and the envelope until USCIS decides the case. Keep your copy afterward as well, since USCIS says its vaccination page serves as an official vaccine record for school or work.

• Since December 2, 2024, USCIS requires Form I-693 to be filed together with your Form I-485. An I-485 sent without it may be rejected.
• Under the USCIS Policy Manual, a form signed on or after November 1, 2023 stays valid while the application it was filed with is pending, and it generally counts only for that application. If that application is denied or withdrawn, a later one needs a new exam.
• The old 60-day limit between the civil surgeon's signature and your filing date no longer applies; USCIS removed it in March 2023.
• CDC requires every part of the exam to be less than one year old when the civil surgeon signs, so older results get repeated. Plan the exam for when you are close to filing.
• For forms signed on or after July 3, 2025, USCIS accepts only the 01/20/25 edition of Form I-693.

USCIS changes these rules, so check the Form I-693 page before you file. Questions about your case belong with USCIS or your immigration attorney; the clinic handles the medical exam.

Only a doctor USCIS has designated as a civil surgeon can complete Form I-693, so a regular family doctor usually cannot, apart from limited military and health department designations. The USCIS Find a Civil Surgeon tool searches by address, city, state or ZIP code, and you can use it to check this clinic as well. The USCIS Contact Center at 800-375-5283 can help too. If you are unsure about any doctor, USCIS suggests asking them to confirm their designation.

Ready to start? Request an I-693 exam time online and the front desk will follow up to confirm it. If you also need a school or work physical, see physicals.