Frequently Asked Questions (FAQs) about the I-693 examination at our office.note¶
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Frequently Asked Questions (FAQs)
about the I-693 examination at our office
Q Does the USCIS authorize you to see an applicant who lives in the U.S. but not in
New York State?
A Yes
Q How quickly can your office see me to perform my green card medical exam (I-
693)?
A You can walk-in any weekday without an appointment. Our office hours are:
9am-7pm Mon–Thu
9am-5pm Friday
9am-12pm Sat (by appointment only)
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 can answer any questions you may have.
Q What is the cost of having my I-693 examination in your office?
A Our base fee is $280. The fee includes an interview, a skin test for tuberculosis (TB), a blood test for
syphilis, a urine test for gonorrhea, and completion of the 13 page I-693 form in 48 hours. The base fee for
children under 15 is $100. They do not require the blood test for syphilis or the urine test for gonorrhea.
Q Are there any charges in addition to the base fee of $280?
A A chest x-ray (CXR) is required if your TB skin test performed by us is 5mm or larger, or if you have an
immunosuppressive condition or take immunosuppressive medications. The charge for a CXR performed in
our office is $80. If you have acceptable proof of having had a TB skin test of 5mm or greater in the past
then you will not require a repeat skin test, but you will still require a chest x-ray.
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 ( ) and CVS pharmacies ( ) 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 bill from the lab for less than $30.
Q Do you accept insurance for the immigration exam?
www.walgreens.com www.cvs.com
A 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 our tax ID number, procedure codes or diagnosis codes for the green card medical exam.
Q How much time does the exam take?
A 2 visits are required.
The first visit can take from 1-2 hours.
The 2nd visit usually takes up to 1 hour.
Q Why are 2 visits required?
A If you require a tuberculosis (TB) skin test you must return 48—72 hours afterwards for your arm to be
inspected for a reaction. Your exam cannot be finalized until the urine test for gonorrhea is completed and
reported negative by our laboratory. The results of this test are available by the beginning of the 2nd day
after your initial visit.
Q Can I eat before arriving?
A Yes
Q Is a urine test required?
A Yes. Please do not pass urine for at least 1 hour before arriving at our office.
Q Do you speak Spanish?
A Yes
Q Do you speak Chinese?
A Yes (most days)
Q Do you speak Arabic?
A Yes
Q Do you speak West African dialects?
A Yes
Q Do you speak French?
A Yes (limited)
Q Do you speak Russian?
A Yes (certain days)
Q Do I need a government ID?
A Yes, and it needs to be currently valid (not expired).
Q Do I need my vaccination record?
A It helps if you have it or can obtain it easily.
Q Can I undergo the exam if I do not have my vaccination records?
A Yes
Q Do I have to repeat my childhood vaccinations if I do not have my record?
A 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.
Q Is a blood test required?
A A blood test for syphilis is required for anyone 15 or older. The test must be performed in our office.
Q Do you take a lot of blood?
A No, we need only part of 1 tube.
Q Is the blood test painful?
A Most people are surprised that there is much less discomfort than they anticipated.
Q I have gotten dizzy or even fainted when having my blood drawn. How will you
manage this problem if you draw my blood?
A We are very experienced in caring for people with this history 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 at the
beginning of your visit to our office.
Q If I present a recent negative blood test report for syphilis will I be required to
repeat the test during this examination?
A Yes. The government requires that a blood test for syphilis be performed by us at the time of your
examination, even if you have recently been tested.
Q What if my blood test for syphilis during my exam is positive?
A 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. 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.
Q Is an HIV test required to complete the I-693 exam?
A No. At your request, however, we can perform an HIV test using the blood sample collected for your
syphilis test. The test result is confidential, takes 10 minutes to complete, and costs $60.
Q Will I require a TB (tuberculosis) skin test (PPD, TST)?
A Yes, usually, unless you can present written evidence on an official laboratory report or vaccination record
or physician or institutional letter that you have had this test in the past and the reading (reaction) measured
5mm. or larger. A report stating “positive” or “negative” is not acceptable to the government. The reading
must be noted in millimeters (mm). Click here for a detailed explanation “
” and “ “.
General Information About The TB
Skin Test Information For People With A Positive Skin Test For TB
Q If I have had a “positive” TB (tuberculosis) skin test (PPD, TST) in the past but do
not have written proof, do I have to have another one if I was told never to repeat
the test again?
A Yes you do, however, there is no permanent harm to you to repeat this test. The skin test will always be
“positive”, but the USCIS requires that we do the test if you do not have proper documentation of your
previous test.
Q Is there some way to avoid having a TB skin test?
A Yes. There is a blood test, QuantiFERON TB, which is acceptable by the USCIS in place of the skin test.
This test requires sending your blood to an outside commercial laboratory which will bill you $95. The turn-
around time is often 3-4 business days.
Q Will a chest x-ray (CXR) be required?
A A chest x-ray is required for anyone with a TB skin test result (in the past or during our examination) of
5mm or greater or with a positive QuantiFERON TB blood test (see above). A prior chest x-ray is not
acceptable. The USCIS does not allow an exception for pregnancy.
Q Can you perform a chest x-ray (CXR) in your office if I require one?
A We are certified by NYC to perform CXRs in our office. The radiation exposure from a single CXR is
minimal. All clients are shielded with a lead apron. 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. There is an $80 fee
for the x-ray and its interpretation.
Q If I have actually had measles or mumps or rubella (German measles) am I
required to have a vaccination called MMR against these diseases?
A 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 ever and 1 shot each for mumps and rubella. 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. 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 1 injection of MMR will be required in order to complete your
examination. The USCIS will not accept your or your doctor’s word that you have had any of these illnesses.
Q Will I require a vaccination for chickenpox (varicella)?
A The USCIS will accept your word if you or a family member remember your having had this disease. If
not, then you will require 1 injection of the vaccine (Varivax) 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. You will be billed $20 for this test directly by the laboratory.
Q Will I require a vaccination for tetanus?
A A tetanus vaccination (Tdap) is required if you do not have written proof of having received a tetanus
vaccination (Tdap or Td) in the prior 10 years. If you do not remember or have no record there is no harm in
receiving a repeat vaccination.
Q Will I require a vaccination for influenza (“flu shot”)?
A Influenza vaccination is required during the U.S. official “flu season” from October 1 through March 31
each year for all applicants 6 months of age or older.
Q If I am or may be pregnant, do I require the vaccination for influenza (“flu shot”)?
A Yes, you require the flu vaccination if you are examined during the official flu season from October 1
through March 31 regardless of pregnancy.
Q Can I get the flu from the flu shot?
A Absolutely not.
Q Do I have to receive vaccinations only from you?
A No. You can have your regular medical provider and some pharmacies administer the vaccinations once
we tell you what is required. 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 8:30 am-2 pm M-F.
They will provide you with a print-out documenting what vaccines were administered and when. We also
provide all vaccines at our office at an extra charge depending on the particular vaccine(s).
Q If I receive vaccinations at your office will I be given documentation for my
personal records?
A Yes. Any vaccinations received at our office will be recorded on your personal copy of your I-693.
Q Can I refuse to take vaccinations for a religious or moral objection?
A Theoretically yes, however, in our experience this exception is difficult to obtain, time consuming, and
often denied by the government.
Q Can my I-693 exam be completed in a single visit?
A 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.
Q 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?
A Yes.
Q What can I do if I have not completed the I-693 in time for my interview
appointment?
A You can start the examination with us and we will give you a note 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 the finalized
examination in the sealed envelope to the USCIS officer.
Q Will you send the sealed/stamped envelope containing my original I-693 to my
lawyer, my employer, or to the USCIS?
A 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.
Q How long is my I-693 exam valid?
A Your I-693 is valid for 12 months from the date of its completion next to the Civil Surgeon’s (Dr. Blau’s)
signature.
Q What can I do if my original, sealed I-693 document is lost?
A We can reproduce your original I-693 document using the prior dates from our archive, however, we
cannot update the document. We charge $20 for this service.
Q 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?
A The USCIS on occasion has not made a new form available until several weeks after it’s official published
date. Even though the USCIS states in the Federal Register that the older form will be acceptable under this
circumstance it has frequently requested that applicants update their form regardless. We consistently begin
using the new I-693 form as soon as it becomes available on line. We cannot be responsible for this
inconsistency by the USCIS. We will, therefore, charge a $20 fee for updating your form.
Q I’m an asylee, a refugee, or on a K-1 visa. Do I need a medical and, if so, what do I
require?
A 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.