If you are adjusting status inside the United States, sooner or later you will read the words civil surgeon. That is the only kind of doctor who can sign your immigration medical exam, and picking the wrong one means paying twice. Here is what a civil surgeon is, what they do and how to show up prepared.
What is a civil surgeon?
A civil surgeon is a physician designated by USCIS to perform the immigration medical exam inside the country and complete Form I-693. The designation is not automatic: the doctor applies, USCIS approves it and lists them in its official finder. A doctor who is not on that list cannot sign your form, however good they are.
Watch out for the most common mix-up: a civil surgeon works inside the United States. If your case is processed at a consulate abroad, the exam is done by a panel physician, which is a different role.
What happens during the exam
The exam follows the CDC technical instructions and has four parts:
- Medical history and vaccination review. This is where most time is lost if you arrive without records.
- Physical exam, including a general check and questions about past illnesses.
- Lab tests, among them tuberculosis screening and the sexually transmitted infection tests that apply for your age.
- Missing vaccines, given at the clinic, plus completing and sealing the form.
The doctor does not decide your immigration case. They only document your health status and hand you the result in a sealed envelope you must not open: if you open it, USCIS can reject it.
What to bring so you don't repeat the visit
- Photo ID and your passport, if you have it.
- Your vaccination record, even if it is from your home country and written in Spanish. Without it, you repeat shots you already had.
- A list of your medications and the names of any conditions you have been diagnosed with.
- Previous tuberculosis results, if you ever tested positive or were treated.
- The USCIS notice for your case, if you already received it.
One detail that saves a trip: the flu vaccine is only required in season, and some vaccines need more than one dose, so ask at your first visit whether your schedule needs a second appointment.
How long is the signed form good for?
Since 2024, USCIS accepts the I-693 with no expiration date as long as the form is properly completed and signed, per the update to its policy manual. It used to expire after two years, and that change still confuses a lot of people.
At La Michoacana
We are a USCIS-authorized civil surgeon: we perform the full I-693 exam, with lab work and vaccines in the same place, in Spanish, and hand you the sealed envelope ready for your case. We are at 6500 Spencer Hwy Ste 180 in Pasadena, open every day. Call us at (832) 617-7439 and ask what to bring before you come; you can also read our guide to the I-693 exam.
