If you are applying for a green card or adjusting your status in the United States, you may be required to complete an immigration medical exam. This exam must usually be performed by a USCIS-designated civil surgeon, not just any doctor.

For many applicants, the term “civil surgeon” can be confusing. It does not mean a surgeon who performs surgery. In immigration, a civil surgeon is a physician authorized by U.S. Citizenship and Immigration Services (USCIS) to complete the medical exam required for certain immigration benefits.

This guide explains what a USCIS civil surgeon is, why you may need one, what happens during the appointment, and how to prepare for your Form I-693 immigration medical exam.

What is a USCIS civil surgeon?

A USCIS civil surgeon is a licensed medical doctor who has been designated by USCIS to perform immigration medical examinations for applicants inside the United States.

The civil surgeon is responsible for completing Form I-693, Report of Immigration Medical Examination and Vaccination Record. This form documents the results of your immigration medical exam, vaccination review, and required screenings.

Only a USCIS-designated civil surgeon may complete the immigration medical exam for most applicants applying from inside the United States. A regular primary care doctor may be able to provide medical records or vaccination history, but they generally cannot complete and sign Form I-693 unless they are designated by USCIS.

Why does USCIS require a civil surgeon?

USCIS requires immigration medical exams to be performed by authorized physicians so the process is consistent, properly documented, and aligned with federal immigration and public health requirements.

The civil surgeon helps determine whether an applicant has certain medical conditions that may affect immigration eligibility. The exam also confirms whether the applicant meets vaccination requirements for immigration purposes.

This does not mean the civil surgeon decides whether your green card is approved. The civil surgeon completes the medical portion of the process. USCIS makes the final decision on your immigration application.

What does a civil surgeon do during the immigration medical exam?

During the immigration medical exam, the civil surgeon and clinic staff typically review your identity, medical history, vaccination records, and required lab testing. The exact steps can vary by applicant, but the process usually includes:

• Identity verification
• Review of medical history and current medications
• Physical examination
• Vaccination record review
• Required screening for certain communicable diseases
• Completion of Form I-693
• Preparation of the sealed I-693 packet for USCIS

The civil surgeon may also determine whether certain vaccines are medically appropriate, whether additional documentation is needed, or whether follow-up testing is required before the form can be finalized.

Civil surgeon vs. regular doctor: what is the difference?

A regular doctor may know your health history, but immigration medical exams have special documentation rules. USCIS requires the exam to be completed by a designated civil surgeon for most applicants inside the United States.

If you need an immigration medical exam, make sure the doctor is specifically authorized as a USCIS civil surgeon before scheduling.

What is Form I-693?

Form I-693 is the official USCIS form used to report the results of your immigration medical examination and vaccination record. After the exam is complete, the civil surgeon signs the form and places it in a sealed envelope.

The sealed envelope is then submitted to USCIS according to your case instructions. In many cases, applicants submit Form I-693 with an adjustment of status application or bring it to a USCIS interview if instructed by their attorney or by USCIS.

You should not open the sealed envelope. Opening it can make the packet unusable and may delay your case.

Who needs to see a USCIS civil surgeon?

Many applicants applying for lawful permanent residence from inside the United States need an immigration medical exam completed by a civil surgeon. This often applies to people filing for adjustment of status, commonly known as a green card application.

You may need a civil surgeon if:

• You are applying for adjustment of status in the United States
• You were asked by USCIS to submit Form I-693
• You received a Request for Evidence (RFE) related to your medical exam
• Your attorney advised you to complete the immigration medical exam
• Your interview notice instructs you to bring a sealed I-693 packet

If you are applying from outside the United States through consular processing, the medical exam is generally performed by a panel physician, not a USCIS civil surgeon. If you are unsure which type of doctor you need, ask your immigration attorney or review your USCIS instructions.

What should you bring to a civil surgeon appointment?

Bringing the right documents can help your appointment go more smoothly and prevent delays with Form I-693. Before your appointment, gather:

• Government-issued photo ID, such as a passport or driver’s license
• Vaccination records, including childhood or international vaccine documents
• Medical records related to major diagnoses, surgeries, or chronic conditions
• Current medication list
• Prior TB test results or chest X-rays, if available
• USCIS notices or attorney instructions, if applicable
• Any prior Form I-693 records, if you completed the exam before

If your vaccination records are in another language, ask the clinic whether translation is needed before the appointment.

How to choose the right USCIS civil surgeon

Choosing the right clinic matters because mistakes in the immigration medical exam can delay your case. When selecting a civil surgeon, consider the following:

• USCIS designation: Confirm that the doctor is authorized to complete Form I-693.
• Immigration exam experience: Choose a clinic familiar with USCIS medical exam requirements.
• Clear instructions: The clinic should explain what to bring and what to expect.
• Lab and vaccine coordination: Ask how required testing and vaccination updates are handled.
• Sealed packet process: Make sure the clinic provides the sealed I-693 packet and a copy for your records.
• Communication: A good clinic should be able to answer timing and documentation questions clearly.

A civil surgeon does not replace your immigration attorney, but the right clinic can help make the medical exam portion of your case more organized and less stressful.

Common mistakes to avoid

Applicants often delay their own medical exam process without realizing it. Common mistakes include:

• Scheduling too close to a USCIS deadline or interview
• Forgetting vaccination records
• Going to a doctor who is not a USCIS civil surgeon
• Opening the sealed Form I-693 envelope
• Assuming every vaccine listed online applies to every applicant
• Not telling the clinic about pregnancy, immune conditions, or vaccine reactions

To reduce the risk of delays, schedule early, bring complete records, and follow the clinic’s instructions carefully.

How Immigration Spot Clinic & Services can help

Immigration Spot Clinic & Services helps applicants complete USCIS-compliant immigration medical exams with clear guidance and organized documentation. Our team can help with vaccination record review, lab coordination, Form I-693 preparation, and sealed packet completion.

If you are preparing for your green card medical exam or need a USCIS civil surgeon, contact us to schedule your immigration medical exam.

Disclaimer: This article provides general information, not legal or medical advice. Immigration requirements can change, and every case is different. Always review current USCIS guidance and consult a qualified immigration attorney or medical professional for your specific situation.