I-693 Medical Exam

 

If you are looking to apply for a Green card or Permanent Residence in the United States, immigration will require you to first get a physical examination. The medical examination must be conducted by a US Civil Surgeon, which is a licensed physician approved by USCIS.  Having the I-693 medical examination done correctly is critical, since the United States Citizenship and Immigration Services will not process your application if it is done incorrectly.
We have the required form. All you need for your immigration physical is a photo ID, any documentation you might have of prior vaccinations and testing, and a form of payment.

We do the minimum required tests and procedures to fulfill the USCIS requirements. You should expect the following during the I-693 Medical Examination:

  • Physical exam
  • Blood Test
  • Urine Test
  • Tuberculosis testing
  • Vaccinations (please bring any vaccination records you may already have, whether from your country of origin or done in the United States)

Once the medical exam is completed, the Civil Surgeon will certify the Form I-693 and you will receive the completed form in a sealed envelope to turn in with your application to the immigration department.

Please DO NOT open the the sealed envelope or it will make your documents inadmissible to the USCIS. Our clinic will provide you with a copy of the documents contained in the sealed envelope for your own records. If you are working with an attorney, we will be happy to send the sealed envelope with the forms directly to the attorney if you want us to do it.

We make every attempt to fill your forms out right so your immigration process goes smoothly. Our track record is very good, and many immigration attorneys refer their clients to us for the immigration physicals. Our job is to conduct the examination in the way that is the best and most cost-effective for you, and in full compliance with the USCIS regulations. We make an effort
to explain our reasons for ordering this or that test or vaccination as we go along with the examination process. If anything is unclear, please make sure to ask. Read the following to be able to better understand the process and possibly save money and aggravation.

The medial exam conducted by our certified Civil Surgeons is valid for one year.

Immunizations

You are required to be immunized completely according to the standard schedule determined by the USCIS. If you have any immunization records, whether American or from your home country, please bring them in. It is best to have them translated, but we can usually figure out even the foreign records and apply all your immunizations towards your INS requirements. Once we know which extra immunizations you need we can give them to you or you can have them done at your primary care doctor’s office.

Children under the age of 19 need the most shots, so please make sure you bring all the available records. We don’t want to give them more shots than they really need.

If you would like to limit the number of immunizations you get, we can do a blood test to verify your immunity to certain childhood illnesses (so called titer). If you test positive for the disease in question, you do not need a shot. We recommend doing titers for measles, mumps and rubella. If you don’t know whether you’ve had chicken pox, we can test for it as well.

If you have had chicken pox (Varicella), you do not need a shot for it. If you don’t know if you have had it, ask your parents whether you did, and at approximately what age. We are allowed to take your word for this disease, but not for others.

Lab tests.

The main blood test we do is for syphilis. This is required for all applicants aged 15 and older. If you choose to do titers for childhood illnesses (see above), they are added to the same test and you don’t need an extra needle stick. Sometimes we need to add other tests (blood or urine) based on the exam findings.

As of August 1 2016 urine test for gonorrhea is required for all applicants aged 15 and older.

HIV/AIDS is defined by the USCIS as “not an infectious disease of public health significance”, so we don’t routinely test for it.  If you would like to be tested, we can do it for you.

 

Tuberculosis Testing.

Skin test for Tuberculosis (PPD or Mantoux) is required for everybody age 2 and up, unless you opt for Quantiferon Gold blood test for TB (see below).

If you have ever had a positive skin test, please let us know and get records to prove it. If you can’t get the record, we may need to repeat the test and it will be positive again. It is not bad and will not affect your immigration process. If you have ever had a positive test, we should avoid repeating it, because it will be positive again and we will not gain any useful information. A positive test means you have had some exposure to TB or received BCG vaccine. Most people have had a vaccination for TB (BCG) in their early childhood, and it often renders them positive on the skin test for the rest of their life.

The test is defined as positive when the area on your forearm that was injected with the “antigen” swells up a bit. Then the doctor would tell you the test is positive and send you for a chest X-ray. So, if you’ve ever had a skin test which was followed by a chest X-ray, the test was probably positive. It would be helpful for us to see the record of the test and the X-ray your doctor did.

In cases when the test was definitely positive in the past and we have a record to prove it, we go straight to chest X-ray, so you avoid an unnecessary needle stick with the following discomfort from the swelling on your forearm.

Another alternative is a blood test called Quantiferon Gold. This test distinguishes a positive skin test due to previous BCG vaccination from one positive due to actual TB exposure. Sometimes it is preferable to other testing methods. For example, if your skin test injection site swells up larger than 9 mm (14 mm for those in the country for 5 years or more without travel outside), you may be required to receive TB prophylaxis with an anti-TB drug for 9 months. Quantiferon Gold test may indicate that the positive result is not due to TB exposure, and you will not need the treatment. We definitely recommend the blood test in these cases to avoid the unnecessary treatment. Pregnancy is no longer a contraindication for the chest x-ray requirement. However, a negative Quantiferon Gold test makes x-ray unnecessary. We will help you decide which method is best and most cost-effective for you.

Our charges

Most of our immigration-related charges are listed below. They are subject to change and may not be updated here immediately, so confirm with our coordinator when you come in or by phone. You may want to call other clinics to compare. You can find all designated civil surgeons here: http://uscis.gov/graphics/surgeonportal.htm

When comparing clinics, make sure to ask how long you may need to wait to get the appointment. We can usually see you and get the forms finished within a week, and in some cases two days is enough. We have the lab and x-ray facilities on premises and do everything needed right away.

The explanation of our prices that follows may be confusing to many.  We are providing this information in an effort to be transparent. Pricing depends on several factors and may be different from person to person.  There may be different ways of handling a situation. We always make an effort to charge you as little as possible.  If something is unclear, please be sure to ask.  The charges can also be discussed with the doctor during your exam, at which time a full explanation will be provided, your options will be discussed, and you will have a say on how to complete your workup most efficiently and at the least expense.

Most adults should expect to pay around $380 for everything necessary. It could be a bit more or less depending on what is needed.

The exam itself is $210 for adults and $190 for children under 15. PPD skin test (for TB) is included. This charge covers all necessary visits and includes all paperwork, including preparation of all the necessary forms in sealed envelopes.

If we have examined you in the past for the same purpose, we will give you a 10% discount on all future immigration exams if you need them. This applies to the exam only, not the other fees. In many cases, no extra immunizations are required for re-examination.

Everything else is added “a la carte”. We will suggest the procedures necessary for the preparation of your form.
Our prices are very competitive because we negotiated a special deal on testing with our lab.

Here are some of the prices:

Chest X-ray: $70.00, including the required reading by a radiology specialist.

Blood test for syphilis: $45.00, plus $15.00 blood draw fee (only one for all the blood tests together, in case you need any others)

Urine test for gonorrhea: $29.00

Quantiferon Gold blood test for TB: $100.00

Immunizations: $22 for administration if free vaccine is available from the MN Dept. of Health (most of the time for most of the vaccines), more if we have to buy it. The prices vary from time to time depending on the price extended to us by the manufacturer for the vaccines we have to buy.  Our front desk person can answer questions regarding specific vaccines at any particular time.  Feel free to call.

Measles, mumps and rubella titers (includes a free MMR shot if indicated): $50 if we have free MMR vaccine from the MDH, $90 if we don’t.

Varicella (chicken pox) titer (if you don’t know whether you’ve had the disease, includes a free shot if indicated): $40 if we have free chicken pox vaccine from the MDH, $70 if we don’t.

Refugee immunization forms (not for adjustment of status): $60.00

Again, if you can have the necessary testing and shots done elsewhere under insurance, do it and we will accept the records.

Contact Us

Address:
Life Medical Building
4215 Excelsior Blvd.
St. Louis Park,
MN 55416
Open:
9:00 am - 5:00 pm
Monday - Friday
Phone:
952-564-3882
Fax:
952-945-9536
eMail
info@civilsurgeons.com

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Any Questions?