If you file Form I-485, Application to Register Permanent Residence or Adjust Status, you typically must undergo an immigration medical examination and receive vaccinations against vaccine-preventable diseases. The examination must be done by a doctor who is designated by U.S. Citizenship and Immigration Services. USCIS designates certain doctors (known as civil surgeons) to perform the immigration medical examination required for most green card applicants. The civil surgeon that conducts your medical examination and review of your vaccination records will then prepare a Form I-693 which will serve as evidence of your compliance with this requirement. A NEW USCIS POLICY requires that an applicant for permanent residency submit a completed Form I-693 WITH their Form I-485 application for adjustment of status or the application will be rejected. WHO CAN PERFORM AN IMMIGRATION MEDICAL EXAMINATION AND COMPLETE THE FORM I-693?  Immigration medical examinations conducted inside the United States must be performed by a civil surgeon who has been designated by USCIS. (Immigration medical examinations conducted outside the United States must be performed by a panel physician who is authorized by the Department of State.). For more information on immigration medical examination, see Form I-693, Report of Medial Examination and Vaccination Record and USCIS Policy Manual Guidance on Health- Related Grounds of Inadmissibility. HOW CAN I FIND A CIVIL SURGEON IN MY AREA to PERFORM THE MEDICAL EXAMINATION AND COMLETE THE FORM I-693? USCIS has a excellent tool on their website which allows you to search for civil surgeons by location and language spoken, so you can find a designated civil surgeon to complete your medical examination who is not only close to you but speaks your language. Further, you can narrow your search down by gender. This is a really great feature they added as it makes the unpleasant task of going to the doctor much more comfortable when you can pick a doctor in your neighborhood who you can communicate with easily…it’s a trip to the amusement park but it makes the process less uncomfortable. To find a designate civil surgeon in your area use the tool on the top of this webpage. What Exactly is the Examination? The immigration medical examination entails a review of your medical history and a physical examination. The civil surgeon will review your medical history and then perform a basic physical examination. As part of the physical examination the civil surgeon will test for communicable diseases such as tuberculosis, syphilis, and gonorrhea, depending on age, as required by the Centers for Disease Control and Prevention (CDC).  After the immigration medical examination, the civil surgeon will complete the Form I-693 and seal the form in an envelope for you to submit to USCIS. They usually stamp the envelope across the fold to ensure the seal is not broken before it is submitted to USCIS. Be careful with the sealed envelope and before you leave the office ensure that it is completely sealed shut. USCIS will not accept the form if the envelope has been opened or altered. It is strongly recommended that you ask the civil surgeon for an extra copy of the completed Form I-693 for your personal records before the civil surgeon seals the original in the envelope. You can review that copy prior to submitting the sealed envelope, so if you notice the civil surgeon made any mistakes (spelling of your name, date of birth, etc.) you can go have it corrected so it will not delay your application. You can find all the details about the Form I-693 on the USCIS website at uscis.gov/i-693. WHAT TO BRING TO YOUR EXAMINATION Bring the following to your medical examination: Vaccination Requirements These Questions and Answers provide basic information about the general vaccination requirements for immigrants (this page does not address the vaccination assessments conducted by panel physicians overseas). For refugees applying for adjustment of status, health department physicians may complete only the vaccination record portion of Form I-693, Report of Medical Examination and Vaccination Record, as blanket-designated civil surgeons. WHAT VACCINATIONS AM I REQUIRED TO GET? Under the immigration laws of the United States, a noncitizen who applies for an immigrant visa abroad, or who seeks to adjust status to that of a lawful permanent resident while in the United States, is required to receive vaccinations to prevent the following diseases: NOTE: If a noncitizen applies for an immigrant visa abroad, that individual has to undergo an immigration medical examination conducted by a panel physician authorized by the U.S. Department of State (DOS). CDC issues separate instructions to panel physicians designated by DOS to conduct immigration medical examinations abroad. For more information about panel physicians, please consult CDC’s and DOS’s websites: Technical Instructions for Panel Physicians | CDC & Medical Examinations FAQs (state.gov). CDC publishes the vaccination requirements and immigration medical examination instructions (including a detailed table listing all required vaccines) at www.cdc.gov/immigrant-refugee-health/hcp/civil-surgeons/index.html. WILL IMMIGRATION FORCE ME TO GET ALL OF THESE VACCINATIONS? No. No Government agency will force you to get any vaccinations. It is your decision whether or not you wish to get vaccinated, however, should you choose not to get the required vaccinations then you will not be admitted to the US as a legal permanent resident–your application will be denied. HOW CAN MY APPLICATION BE DENIED BECAUSE OF VACCINATION RECORDS? Under the Immigration and Nationality Act (INA) section 212(a)(1)(A)(ii), a noncitizen who seeks admission as an immigrant or who seeks adjustment of status to that of a lawful permanent resident, who fails to show proof that they were vaccinated against vaccine-preventable diseases, is inadmissible and therefore ineligible for admission or adjustment of status. LEGAL AUTHORITY FOR IMMIGRATION VACCINATION REQUIREMENTS The legal foundation for this authority is found in Title 8: Aliens and Nationality and Title 42: The Public Health and Welfare of the U.S. Code (USC), and relevant supporting regulations at Title 42 Public Health in the Code of Federal Regulations (CFR). Title 8 of the U.S. Code: Aliens and Nationality Title 42 of the U.S. Code: The Public Health and Welfare Title 42 of the