What Are the Green Card Medical Exam Requirements?

Applying for a green card can feel straightforward, until the medical exam enters the picture. What exactly are officials looking for, and why do some applications stall at this stage? In this guide, we break down the green card medical exam requirements, clarify what’s mandatory versus misunderstood, and explain how to avoid surprises that could delay your immigration process.

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TL;DR:

Most green card applicants must complete a required medical exam as part of the immigration process. The exam includes a vaccination review, screening for communicable diseases and certain physical or mental conditions, and a focused physical evaluation based on immigration guidelines. Results are documented on Form I-693, sealed, and submitted according to application type. Missing steps or improper submission can delay or prevent approval.

Who Must Complete a Green Card Medical Exam in New York?

If you are applying for lawful permanent residency in the United States, you are generally required to complete a medical examination as part of the process. This requirement applies in New York, just as it does in every other state.

Most applicants applying from within the U.S. must complete the exam when filing Form I-485, the application used to adjust status to permanent resident. A completed medical exam report (Form I-693) must be included and signed by an immigration-authorized physician. Failing to submit this documentation can result in delays or rejection of the application.

This requirement typically applies to family-based, employment-based, diversity lottery, refugee or asylee adjustment, and fiancé(e) categories. Applicants pursuing permanent residency from outside the U.S. must also complete a comparable exam before their immigrant visa interview, with results submitted to immigration authorities or provided in a sealed envelope.

Only very limited exceptions exist, such as certain applicants with prior screenings or an approved waiver. In most cases, completing the medical exam is a mandatory step before a green card can be approved.

Vaccinations Needed for the Green Card Exam

An essential part of the green card medical exam is the vaccination review. U.S. immigration law requires applicants to show proof of immunity or receive certain vaccines to help protect public health. The list of required immunizations is based on guidelines established by the CDC and is reviewed during the medical exam.

As of the latest guidelines (2025–2026), required vaccinations include:

• Measles, Mumps, Rubella (MMR)
• Tetanus and Diphtheria (Td or Tdap)
• Pertussis (Whooping Cough)
• Polio
• Hepatitis A and B
• Haemophilus influenzae type B (Hib)
• Meningococcal disease
• Pneumococcal disease
• Varicella (Chickenpox)
• Rotavirus (for eligible children)
• Seasonal influenza (when applicable)

There are several important points to keep in mind. The COVID-19 vaccine is no longer required for green card medical exams following updates in 2025. If you do not have vaccination records, the immigration-authorized physician will determine which immunizations are needed and may administer them during the exam. In some cases, medical or religious exemptions can be documented, but refusing required vaccines without valid documentation may negatively affect your application.

Medical Conditions Checked During the Exam

The green card medical exam is intended to identify medical conditions that could make an applicant inadmissible on public health grounds. Under U.S. immigration law and CDC technical guidelines, the exam focuses on specific health areas that may affect eligibility.

Communicable diseases are a primary focus of the evaluation. Applicants are screened for conditions considered significant to public health, including active tuberculosis (TB), syphilis, gonorrhea, and infectious Hansen’s disease (leprosy). These conditions require careful review because of their potential impact on others.

The exam also assesses other health conditions that may affect safety or daily functioning. This includes reviewing physical or mental disorders that could interfere with normal activities or pose a safety concern, as well as any history of drug abuse or addiction.

If a serious condition is identified, treatment may be required before the immigration process can move forward. Completion of treatment is often necessary prior to approval of the application.

Tuberculosis and Other Infectious Disease Screening

A critical part of the green card medical exam is screening for tuberculosis (TB) and other infectious diseases that could pose public health concerns. These screenings are required before an application can move forward.

• TB Screening
  All applicants aged 2 years and older must undergo TB testing. This is typically done using an interferon-gamma release assay (blood test) or a skin test. If the initial test is positive, a chest X-ray is required to determine whether active disease is present.
• Syphilis and Gonorrhea
  Applicants are also screened for syphilis and gonorrhea. Syphilis testing is performed through a blood test, while gonorrhea screening involves a urine or swab test, depending on age and risk factors.

These infectious disease screenings help ensure that conditions posing public health risks are identified and addressed before a green card is granted.

How the Physical Examination Is Conducted

The physical examination in a green card medical exam focuses on overall health while specifically evaluating immigration-related medical criteria. It is not a full primary care check-up, but a targeted assessment required for the application process.

During the visit, the civil surgeon will review your medical history, including:

• Past illnesses and hospitalizations
  
• Previous surgeries
  
• Chronic medical conditions
  
• Current medications
  

The physical exam itself includes a general evaluation of some body systems:

• Eyes, ears, nose, and throat
  
• Heart, lungs, and abdomen
  
• Skin, lymph nodes, and extremities
  
• Mental status and behavioral health
  

Depending on age and risk factors, the surgeon may also request additional testing, such as:

• Laboratory tests (for example, TB screening or syphilis testing)
  
• Diagnostic imaging, including a chest X-ray
  

Overall, the exam is designed to meet CDC and USCIS health requirements, focusing only on conditions relevant to immigration eligibility rather than comprehensive medical care.

Steps to Submit Your Medical Exam Results

Once your medical examination is complete and all required tests and vaccinations have been finished, the civil surgeon will complete and sign Form I-693, officially documenting your results. Afterward, the form is placed in a sealed envelope, which must remain unopened, as immigration authorities require the report to stay sealed.

If you are applying through Adjustment of Status from within the United States, the sealed Form I-693 should be submitted with your Form I-485 or brought to your interview if specifically instructed. Submitting the form at the wrong time can lead to delays or rejection of your application.

For consular processing from outside the United States, the sealed envelope may need to be brought to your visa interview, or the results may be sent directly to the U.S. consulate, depending on local instructions. If you are given a personal copy of the exam, keep it for your records only, as an opened original will not be accepted.

Key Takeaways

1. Who must complete the exam
   Most people applying for lawful permanent residency must complete a medical exam, whether applying from inside the U.S. or through consular processing abroad. The exam is mandatory in nearly all categories, with only limited exceptions. Missing or incorrect submission can delay or jeopardize approval.
   
2. Vaccination requirements
   Applicants must show proof of immunity or receive vaccines required under CDC guidelines. These include routine and age-appropriate immunizations, while the COVID-19 vaccine is no longer required as of 2025. Lack of records may require vaccinations during the exam.
   
3. Conditions screened during the exam
   The exam focuses on public health concerns and safety-related conditions. Screening includes certain communicable diseases, as well as physical or mental conditions and substance-related issues that may affect daily functioning or safety.
   
4. Infectious disease testing
   Testing for tuberculosis is required for applicants aged two and older, with follow-up imaging if needed. Screening for syphilis and gonorrhea is also conducted based on age and risk factors to reduce public health risks.
   
5. Exam process and submission steps
   The physical exam reviews medical history, body systems, and may include labs or imaging. Results are documented on Form I-693, sealed, and submitted according to application type; opening the sealed form can result in rejection.

FAQs: 

What medical conditions disqualify you from a green card?

 Conditions that may affect eligibility include certain communicable diseases of public health significance, serious physical or mental disorders that pose a safety risk, and drug abuse or addiction. Some conditions may require treatment before approval rather than result in permanent disqualification.

What is the medical exam form for a green card?

 The required form is Form I-693, officially titled the Report of Medical Examination and Vaccination Record. It must be completed and signed by an immigration-authorized physician and submitted in a sealed envelope.

What are the medical tests for a U.S. green card?

 Medical tests typically include tuberculosis screening (blood or skin test, with chest X-ray if needed), syphilis blood testing, and gonorrhea testing (urine or swab), along with a vaccination review and physical exam.

What diseases disqualify you for the green card?

 Diseases that can affect eligibility include active tuberculosis, syphilis, gonorrhea, and infectious Hansen’s disease (leprosy). These conditions must be identified and addressed before a green card can be approved.

Sources. 

Centers for Disease Control and Prevention. (2025, March 11). CDC’s role in immigration. U.S. Department of Health and Human Services. https://www.cdc.gov/immigrant-refugee-health/about/cdc-role-in-immigration.html

U.S. Citizenship and Immigration Services. (2025, July 8). Report of immigration medical examination and vaccination record (Form I-693). U.S. Department of Homeland Security. https://www.uscis.gov/i-693