Anthony Blau MD, Civil Surgeon, New York City
I-693 Immigration Medical Exam  |  212-766-4433

Anthony Blau MD | Civil Surgeon, NYC
I-693 Immigration Medical Exam
212-766-4433

Frequently Asked Questions (FAQs) about the I-693 examination at our office

Frequently Asked Questions (FAQs) about the I-693 examination at our office

Does the USCIS authorize you to see an applicant who lives in the U.S. but not in New York State?
Yes

How quickly can your office see me to perform my green card medical exam (I-693)?

You can walk in any weekday without an appointment. Our office hours are:

  • Mon–Fri | 9am-6pm

Although it’s not required, we appreciate it if you call us first at 212-766-4433 during office hours so that we can advise you about what you should bring with you and answer any questions you may have.

What is the cost of having my I-693 examination in your office?
Our base fee is $380. The fee includes an interview, a blood test for tuberculosis (TB), a blood test for syphilis, a urine test for gonorrhea, and completion of the 14 page I-693 form in 2 business days. The base fee for children under 18 is $100. They do not require the blood test for syphilis or the urine test for gonorrhea. A blood test for tuberculosis (TB) is required for children ages 2 and over, but we usually do not perform this test for children at our office. We recommend you arrange for their pediatrician to draw blood and order a test called a QUANTIFERON, and we will complete the I-693 form for them once that has been completed.

Are there any charges in addition to the base fee of $380?
If you require any vaccinations for your examination, it will be determined during your initial interview in our office. Vaccinations performed in our office are at extra cost. The cost varies according to the particular vaccination. Many clients prefer to go to the NYC Department of Health (NYCDOH) where they can receive most vaccines either free or for a minimal administration fee of less than $20. We will advise you of what you require and assist you in getting to the NYCDOH. If you have medical insurance and your plan includes vaccinations most Duane Reade (www.walgreens.com) and CVS pharmacies (www.cvs.com) administer the flu shot and accept insurance. Some of them employ licensed professionals who can administer additional vaccines as well, usually by appointment.

If your blood test for syphilis in our office is positive we are required to send your blood to a commercial laboratory for confirmation. You will receive a separate bill from the lab (they charge approximately $30).

Do you accept insurance for the immigration exam?
Unfortunately medical insurance companies do not cover the immigration medical exam. If you are intending to submit a claim to your insurance company on your own, please be advised that we are unable to provide a tax ID number, procedure codes or diagnosis codes for the exam.

How much time does the exam take?
2 visits are required. The first visit can take from 1-2 hours, the second visit usually takes up to 1 hour.

Why are 2 visits required?
The required laboratory testing of your blood and urine for tuberculosis, gonorrhea and syphilis requires approximately 36 hours to complete. Your exam cannot be finalized until these tests are completed and reported negative by our laboratory. You will need to return after your results are ready (usually 2 days after your initial visit) in order to sign and pick up your completed paperwork.

Can I eat before arriving?
Yes. In fact, we recommend eating and hydrating before you arrive, as it makes it easier and more comfortable for you when you are having your blood drawn.

Is a urine test required?
A urine test for Gonorrhea is required if you are 18–24 years old. If you are in this age category, please do not urinate for at least one hour before arriving at our office.

Does your staff speak Spanish?
Yes, we have a native Spanish-speaker in the office on most days.

Does your staff speak Chinese?
Yes, we have a native Chinese-speaker in the office on most days.

Does your staff speak Arabic?
Yes, we have a native Arabic-speaker in the office on most days.

Does your staff speak any West African dialects?
Yes, several, including Wolof, Mandinka and Fulani.

Does your staff speak Russian?
Yes, on some days. Please call ahead to find out when.

Do I need a government ID?
Yes, and it must be currently valid (not expired).

Do I need my vaccination record?
It helps if you have it or can obtain it easily. Children under the age of 18 are required to have vaccination records.

Can I undergo the exam if I do not have my vaccination records?
Yes.

Do I have to repeat my childhood vaccinations if I do not have my record?
No, but you may require one or more adult vaccinations depending on your age and what vaccinations you may have received in the recent past. Your particular requirement, if any, will be determined during your initial visit.

Is a blood test required?
A blood test for syphilis is required for anyone aged 18–44. Additionally, a blood test for tuberculosis is required for anyone 2 years of age and older. For patients below the age of 18, we request that the blood test for tuberculosis be performed by their own pediatrician. If obtaining an appointment with a pediatrician for children under 18 is difficult, please call our office and we can try to help make arrangements for them in our office.

Do you take a lot of blood?
No, we only need a very small amount.

Is the blood test painful?
Most people are surprised that there is much less discomfort than they expect. For most people, it feels like a sharp pinch, and is over in a matter of seconds.

I have gotten dizzy or even fainted when having my blood drawn. How will you manage this problem if you draw my blood?
We are very experienced in caring for people with this issue and we can often prevent this reaction by lying you down with your legs elevated before the procedure. If, in spite of this precaution, you do have a reaction we will have you in a safe position and care for you until you have completely recovered. You will be specifically asked about your history of such a reaction when filling out our medical questionnaire.

If I present a recent negative blood test report for syphilis will I be required to repeat the test during this examination?
Yes. The government requires that a blood test for syphilis be performed by the Civil Surgeon (that’s us) at the time of your examination, even if you have recently been tested.

What if my blood test for syphilis during my exam is positive?
Your blood will be submitted, as required by the USCIS, to a commercial laboratory to confirm our finding with a different test that cannot be performed in our office. If your blood is confirmed positive for syphilis you will require completed treatment by the public health authorities or by a private physician, after which we can finalize your I-693 examination. The treatment can take up to 3 weeks in some cases. If your blood test is positive due to a previous infection for which you have already been appropriately treated, we will require information about the time, place, and type of treatment you’ve received. You will receive a bill from the commercial laboratory for approximately $30 for the syphilis confirmation testing.

Is an HIV test required to complete the I-693 exam?
No.

Will I require a TB (tuberculosis) skin test (PPD, TST)?
No. As of October 1, 2018 USCIS is no longer allowing tuberculosis (TB) screening by skin test. Instead, they are requiring a more specific type of test called an IGRA blood test. There are two commercially available IGRA blood tests for tuberculosis: QUANTIFERON and the T-Spot test. We perform the QUANTIFERON assay in our office, which allows us to complete your paperwork in 48 business hours and prevents you from getting a large separate bill from an outside medical laboratory.

Will a chest x-ray (CXR) be required?
A chest x-ray is required for anyone with a positive QUANTIFERON TB blood test (see above). The Department of Immigration does not accept a previously performed chest x-ray as a substitute. The USCIS also does not allow an exception for pregnancy. However, if your blood test for tuberculosis turns out to be positive, we will perform the chest x-ray for you in our office at no additional fee.

Can you perform a chest x-ray (CXR) in your office if I require one?
We are certified by NYC to perform chest x-rays in our office. The radiation exposure from a single x-ray is minimal. The test takes 5-10 minutes to complete by our certified x-ray technologist or by Dr. Blau. The USCIS accepts our doctor’s official interpretation.

If I have actually had measles or mumps or rubella (German measles) am I required to have a vaccination called MMR against these diseases?
If you were born after 1956 you are required to have written proof, with the dates of administration, of having received 2 shots for measles and 1 shot each for mumps and rubella, at some time in the past. Alternatively, the government will accept documentation of a blood test demonstrating a protective level of antibodies to each of these diseases. We can send a sample of your blood to a commercial laboratory to perform this antibody test. If you choose to have your blood tested for antibodies, you will be billed $20 for this test directly by the laboratory for each of the antibody tests performed. If you require MMR vaccination, only one (1) injection of MMR will be required in order to complete your examination. Unfortunately, the Department of Immigration will not accept your or your doctor’s word that you have had any of these illnesses.

Will I require a vaccination for chickenpox (varicella)?
The USCIS will accept your word if you or a family member remember that you had this disease. If not, then you will require one (1) injection of Varivax, the vaccine that protects against this disease. Alternatively, the government will accept documentation of a blood test demonstrating a protective level of antibody against this disease. We can send a sample of your blood to a commercial laboratory to perform this antibody test. If you choose to have your blood tested for antibodies, you will be billed $20 for this test directly by the laboratory.

Will I require a vaccination for tetanus?
A tetanus vaccination (Tdap or Td) is required if you do not have written proof of having received a tetanus vaccination in the prior 10 years. If you do not remember or have no record, there is no harm in receiving a repeat vaccination.

Will I require a vaccination for influenza (a “flu shot”)?
Influenza vaccination is required during the official “flu season”, which runs from October 1st through March 31st each year for all applicants 6 months of age or older.

If I am or may be pregnant, do I require the vaccination for influenza (a “flu shot”)?
Yes, Immigration requires that you receive the flu vaccination if you have your examination during the official flu season (October 1st through March 31st), even if you are pregnant at the time.

Can I get the flu from the flu shot?
Absolutely not.

Do I have to receive vaccinations only from you?
No. You can have your regular medical provider and some pharmacies administer the vaccinations once we determine what is required in your case by USCIS. We also send many applicants to the NYC Department of Health (NYCDOH) vaccination center in downtown Brooklyn where they can be vaccinated for a minimal administration fee of about $20 and save significantly on the cost of the vaccines. The center is open from 8:30am–2pm, Monday–Friday. They will provide you with a print-out documenting what vaccines were administered and when. We can also provide all vaccines at our office, should you prefer to do them with us, for an additional charge, depending on the vaccine(s) given.

If I receive vaccinations at your office will I be given documentation for my personal records?
Yes. Any vaccinations received at our office will be recorded on your personal copy of your I-693.

Can I refuse to take vaccinations for a religious or moral objection?
Theoretically yes, however, in our experience this exception is difficult to obtain, time consuming, and often denied. If you or your attorney are applying for a vaccination waiver (Form I-601), please bring a copy of the completed form to us when you come in for your exam.

Can my I-693 exam be completed in a single visit?
In certain cases it may be possible to complete your forms in a single visit. Please call us at 212-766-4433 to discuss whether this is possible in your case.

Will I receive a copy of my I-693 examination for my personal records, in addition to the original I-693 in the sealed envelope?
Yes.

What can I do if I have not completed the I-693 in time for my interview appointment?
You can start the examination with us and we will give you a receipt to take to your scheduled interview with an explanation to the USCIS officer that the examination is in process and will be completed within the following 1–2 days. After you complete your examination with us, you will then return to USCIS with the finalized examination in the sealed envelope and give it to the adjudicating officer.

Will you send the sealed/stamped envelope containing my original I-693 to my lawyer, my employer, or to the USCIS?
No. We give the sealed/stamped envelope and your copy to you at the end of your examination with us. It will be your responsibility to submit the document to whomever is assisting you or directly to the USCIS.

How long is my I-693 exam valid?
According to the Department of Immigration, they will honor the I-693 for 2 years from the date of the exam (the date next to the civil surgeon’s signature on the form).

What can I do if my original, sealed I-693 document is lost?
We can reproduce your original I-693 document (providing the forms have not been changed by USCIS) using the prior dates from our archive, however, we cannot update the document. We charge $20 for this service.

If I receive a notice from the USCIS to have my I-693 rewritten on an updated form can you do this, and is there a charge for the service?
The Department of Immigration, on occasion, has delayed the availability of new forms until several weeks after their official publication date. Even though USCIS states in the Federal Register that the older form will be acceptable under this circumstance, individual immigration agents will sometimes request that applicants update their form regardless. We begin using the new I-693 form as soon as it becomes available online. We can’t be responsible for the unpredictable requests of individual USCIS agents, and therefore charge a $60 fee for updating your form should they require it. We will also need to fulfill any updated requirements for the I-693 that have been issued by Immigration in the interim.

I’m an asylee, a refugee, or on a K-1 visa. Do I need a medical and, if so, what do I require?
You may or may not require a medical and if so it will depend on your particular circumstances. You should call us at 212-766-4433 and speak to our office manager, Nari Singh, to determine what you require and when.