Civil Surgeon: What They Do and How to Find One in 2026

If you are applying for a green card from inside the United States, at some point you will need to see a civil surgeon. This is the doctor who completes your immigration medical exam and signs Form I-693, the report U.S. 

Citizenship and Immigration Services (USCIS) uses to confirm you are not inadmissible on health-related grounds. Since December 2, 2024, you generally must submit that form together with your Form I-485, or the agency may reject your application. The exam usually costs $200 to $500, plus any vaccines you still need. 

This guide covers what the doctor does, who needs one, how to find one, and ends with an FAQ on the questions applicants ask most.

What is a civil surgeon?

A civil surgeon is a physician USCIS has authorized to perform immigration medical examinations inside the United States. If you are adjusting status to lawful permanent residence, this is the only doctor whose exam the agency will accept. Despite the name, the role has nothing to do with civil law, a civil case, or civil rights, and it does not involve surgery.

The title simply means the doctor holds a USCIS designation to assess whether you have any condition that would make you inadmissible on health-related grounds, and to record the results on Form I-693. Every civil surgeon USCIS designates is added to a public list you can search before you book.

What does a civil surgeon do?

When you book a civil surgeon appointment, the physician works through a fixed checklist set by the Centers for Disease Control and Prevention (CDC). The job is to document your health on Form I-693 so the agency can decide on admissibility. The exam covers several distinct tasks:

• Identity and medical history: The doctor verifies your identity against a photo ID and reviews your medical history.
• Physical and mental examination: A physical examination and a basic mental-status check screen for conditions relevant to admissibility.
• Vaccination review: The doctor checks your vaccination record against the required vaccinations and gives any doses you are missing.
• Disease screening: You are tested for communicable diseases of public health significance, such as tuberculosis.
• Completing the form: Finally, the doctor signs and seals a completed Form I-693.

Who must see a civil surgeon?

You need one if you are applying for permanent residence through adjustment of status while physically present in the United States. Most applicants in this group complete the full immigration medical examination, but there are a few variations:

• Full exam required: Most applicants filing Form I-485 need the complete medical exam and immunization history.
• Vaccination record only: Some refugees and asylees already examined abroad by a panel physician only need the vaccination portion of Form I-693 completed.
• No civil surgeon needed: If you apply for an immigrant visa from outside the United States, you will see a panel physician instead.

How to find a USCIS-designated civil surgeon near you? 

If you are searching for a civil surgeon near me, the most reliable starting point is the official USCIS civil surgeon locator on USCIS.gov. The agency keeps a current civil surgeon list, and only a doctor on it can sign your Form I-693, so confirm the listing before you book. Your own primary care doctor or any other health care provider cannot sign the form unless they hold the designation.

To find a civil surgeon, use the Find a Civil Surgeon tool on USCIS.gov and search by ZIP code; most metro areas have several listed providers. Refugees can also complete the vaccination portion at certain state and local health departments, which hold blanket (automatic, agency-wide) designations.

What should you expect at your immigration medical exam?

Your civil surgeon appointment is usually a single visit that includes a physical exam, lab work, and a vaccination review. Bring everything the exam requires:

• What to bring: A government-issued photo ID such as a passport or driver’s license, your vaccine records, and your health history, including any prior treatment for tuberculosis.
• Tuberculosis testing: Applicants 2 and older get a tuberculosis (TB) blood test. A positive result triggers a follow-up chest X-ray and further evaluation.
• Blood and lab tests: Applicants 15 and older are screened for syphilis and gonorrhea through blood work and other lab tests.
• Vaccinations: Civil surgeon vaccinations follow the CDC schedule and the federal vaccination requirements. The doctor reviews your immunization record and gives missing age-appropriate doses, such as MMR (measles, mumps, and rubella), varicella, and hepatitis B, on the standard pediatric and adult schedules.

The civil surgeon cost typically runs $200 to $500, plus the price of vaccines, and most health insurance plans do not cover immigration medical examinations. The civil surgeon fee 2026 applicants pay sits in that same range.

Health-related grounds of inadmissibility the exam checks for

The point of the exam is to tell the agency whether you fall under any health-related ground of inadmissibility. You will not be penalized for an honest health history; the goal is to identify conditions, not to disqualify you. The findings fall into two categories:

• Class A conditions: These can bar admission and include communicable diseases of public health significance (such as active tuberculosis or infectious syphilis), certain mental disorders associated with harmful behavior, and drug abuse or addiction.
• Class B conditions: These are significant health issues that do not bar admission but may require follow-up, treatment, or monitoring.

A Class A finding does not always end your case. A waiver exists for some conditions, and a missed vaccination can sometimes be resolved with a waiver too, so talk to an immigration attorney first.

Form I-693: how results are reported and submitted

Once your exam is done, the doctor records everything on Form I-693, signs it, and seals it inside an envelope with a signature across the flap. You must submit that sealed envelope to USCIS unopened; if the seal is broken or shows tampering, the agency will not accept the form and you may have to repeat the exam.

Before the doctor seals it, ask for a copy for your records so you can review the results and keep your vaccine records.

Since December 2, 2024, you generally must file the completed Form I-693 with your Form I-485. Always confirm you are using the current Form I-693 edition on USCIS.gov, since the agency accepts only the latest version.

How long Form I-693 stays valid with USCIS

Your civil surgeon I-693 exam used to be valid for 2 years for everyone, but that changed in 2024. If your form was signed on or after November 1, 2023, it does not expire on a fixed date and stays valid for as long as the application you filed it with is pending.

If that case is later denied or withdrawn, a future filing needs a fresh exam.

Forms signed before November 1, 2023, still follow the older 2-year validity from the signature date. USCIS removed the old rule requiring a signature within 60 days of filing back in 2023, so there is no longer a short window between the exam and your filing. USCIS officers can still request a new exam if they believe your condition has changed.

Civil surgeon vs. panel physician: what’s the difference?

If you are weighing civil surgeon vs panel physician, the difference comes down to where you are and which agency designates the doctor. You see one when you apply from inside the United States, and a panel physician when you apply for an immigrant visa abroad.

Both roles follow the same CDC Technical Instructions and report results on the same kind of medical examination, so the standards stay consistent even though the location and approval process differ.

How to become a civil surgeon if you are a physician

If you are a physician who wants to add immigration exams to your practice, knowing how to become a civil surgeon comes down to a few clear steps. You must hold an unrestricted MD or DO license and have practiced medicine for at least 4 years after completing training; internships and residencies do not count. The steps are straightforward:

1. Confirm eligibility. Verify your license is active and unrestricted and that you meet the 4-year experience requirement.
2. File Form I-910. Submit Form I-910, Application for Civil Surgeon Designation, with proof of your degree, licenses, and experience. The filing fee is $785; confirm the current amount on the official fee schedule before you submit.
3. Maintain the designation. After USCIS grants your civil surgeon designation, follow the CDC Technical Instructions and report every result accurately.

Military physicians and certain health department doctors hold blanket designations and do not file Form I-910.

Get your medical exam filed right with Lighthouse

Form I-693 sits at the intersection of your medical exam, your civil surgeon, and your adjustment of status filing. Getting it right means using the current form edition, choosing a doctor on the USCIS-designated list, and keeping the envelope seal intact from the exam room to the agency. Small mechanical errors here trip up more submissions than actual medical findings do — and a single broken seal, expired edition, or unlisted surgeon can trigger a Request for Evidence or stall an otherwise solid case.

Lighthouse helps applicants navigate these requirements through expert case management and technology built for immigration workflows. Our team confirms your civil surgeon is properly designated, checks that you're filing the current form edition, and reviews your sealed medical package before it ever reaches USCIS. Every case gets attorney review to ensure your filings meet USCIS standards, most evaluations turn around in under 3 weeks, and if a Request for Evidence does come up, we handle the response at no additional charge.

Start your free evaluation today.

Frequently asked questions on civil surgeons

What does a civil surgeon do? 

The doctor performs your immigration medical exam and records the results on Form I-693, including a review of your health history, a physical examination, a vaccination check, and screening for tuberculosis and other infectious diseases. The signed, sealed form is what USCIS uses to decide whether you are admissible on health grounds.

How much do civil surgeons make? 

There is no fixed salary, because the designation is something physicians add to an existing practice rather than a separate job. They earn the exam fee per applicant, typically $200 to $500 before vaccines or lab work, so income depends on volume.

Do doctors get green cards faster? 

Being a civil surgeon does not speed up anyone’s case. Foreign-national physicians do have dedicated pathways, such as the EB-2 national interest waiver and the Conrad 30 program for J-1 waivers, but those are unrelated to the designation itself.

How long does it take to become a civil surgeon? 

The main gate is the 4-year experience requirement, which must be met before you apply. Once you qualify and file Form I-910, USCIS typically adjudicates the application within a few months, though times vary with workload.