What immigration medical exam do foreigners need in the United States in 2026?

Adjustment of status (inside the United States). USCIS requires Form I-693, Report of Immigration Medical Examination and Vaccination Record, completed by a designated civil surgeon. Only listed civil surgeons may sign the immigration exam for USCIS benefits processed in the United States. After the visit, the civil surgeon returns a signed I-693 in a sealed envelope. You submit that packet with Form I-485; USCIS guidance effective December 2, 2024 expects the medical (or a partial vaccination record where allowed) to arrive with the adjustment filing or the I-485 may be rejected. If you file I-485 online, follow the current upload rules for the sealed packet and keep the original for interview.

Immigrant visa (consular processing abroad). You generally do not use Form I-693. A DOS Panel Physician in the country where you process completes the medical and vaccination assessment under CDC technical instructions for panel physicians. Results go into the consular packet rather than a USCIS civil-surgeon envelope.

Refugees and some special categories have partial exceptions (for example vaccination-only I-693 pieces at adjustment). Ordinary B-1/B-2 visitors extending stay do not take this exam for Form I-539.

Civil surgeons and panel physicians follow CDC technical instructions. They evaluate communicable diseases of public health significance, certain physical or mental disorders with associated harmful behavior, drug abuse or addiction, and age-appropriate required vaccines. Bring written immunization records so the doctor can transfer valid doses instead of repeating every shot. Missing vaccines can often be given at the appointment or documented later for blanket or individual waivers when the instructions allow.

This immigration exam is not the same as a state DMV vision test, an employer occupational physical, or ordinary primary care. Clinic language help for day-to-day visits is covered in English at clinic; insurance shopping for living costs sits in Choose health insurance. Neither replaces Form I-693 or a Panel Physician report.

Keep your I-94 and civil documents aligned with the name on the medical form. After you become an LPR, long trips may later involve a reentry permit; that Form I-131 product does not redo the immigration medical.