1. Choose a “Civil Surgeon”
a. Call 1-800-375-5283 (English and Spanish), or
b. Find one here
2. Before the Medical Exam
a. Bring your Passport as proof of identification
b. Bring any vaccination records you have
3. During the Medical Exam
a. Usually: Chest X-ray, serology test, and a review of vaccination records to determine whether you have all your vaccinations
v. Tetnus and Diptheria Toxoids
vii. Influenza Type B
viii. Hepatitis B
ix. Varicella (Chickenpox)
x. Hemophilus Influenza Type B
xiii. Hepatitis A
xv. Human Papillomavirus (for females between 11 and 26)
All doses of the required vaccines need to be given. Because completion of the vaccine series often requires several months, applicants are not required to have received all doses of the ACIP-recommended vaccines to fulfill the vaccination requirements for adjustment of status to U.S. permanent residence. Rather, applicants are required to have received at least one dose of each vaccine and are encouraged to follow up with a primary health-care provider to complete the series once they are in the United States. Source:
xvii. For a person who has had no vaccines or whose vaccines are not up to date, doVaccination Technical Instructions for Civil Surgeons, Frequently Asked Questions
4. Report of the Civil Surgeon
a. The Alien is in full compliance with the vaccination requirement;
b. The Alien lacks certain vaccines but is eligible for a “not medically appropriate”waiver
i. a vaccine is not recommended for the alien’s age group (for example, infants and adults do not need meningococcal vaccine, and adults do not need Haemophilus influenzae type b vaccine.);
ii. a vaccine is medically contraindicated (note the following general guidelines:
1. severe (anaphylactic) allergic reaction to a vaccine component or following a prior dose of a vaccine is a contraindication;
2. severely immunocompromised conditions are a contraindication for receiving live attenuated vaccines: measles-mumps-rubella (MMR), varicella, zoster, influenza;
3. pregnancy is a contraindication for receiving live attenuated vaccines: MMR, varicella, zoster, influenza;
iii. Encephalopathy not due to another identifiable cause is a contraindication for administration of DTaP if it occurred within 7 days of a previous dose of DTP or DTaP);
iv. the alien received a dose of a required vaccine prior to the medical examination, and the minimum interval for receipt of the next required dose has not passed (e.g., the recommended series of hepatitis Bvaccines may take as long as six months to complete);
v. a vaccine is not appropriate for the season (the influenza vaccine is only administered to age appropriate applicants during the fall season).
c. A missing vaccine is medically appropriate but the alien has religious reasons for refusing the vaccine.
5. If any of these situations apply, the civil surgeon will certify the alien’s eligibility for a “not medically appropriate” waiver. This is a blanket waiver and a separate waiver application on Form I-601 is not required in these cases.
6. Civil surgeons will not administer a dose of a missing vaccine if the applicant indicates that he or she does not wish to comply with the vaccination requirement because of religious or moral reasons. In these cases the alien must file Form I-601 to request a waiver of the vaccination requirement. The application must be filed with the applicable filing fee ($545). To qualify for such a waiver the alien must show that:
a. he or she is opposed to vaccinations in any form;
b. the objection is based on religious beliefs or moral convictions; and
c. the religious belief or moral conviction is sincere. When the waiver application is for a child, the child’s parent must satisfy these three requirements.
7. After the Medical Exam
a. The Civil Surgeon will complete the paperwork
b. The Civil Surgeon will instruct you to sign page one – DO NOT SIGN UNTIL INSTRUCTED TO DO SO
c. Use Blank Ink only
d. Complete date signed
e. Add social security number if you have one
a. The Civil Surgeon will provide you with the Chest X-ray (keep this in your records as you may be asked for it in a later interview)
b. The Civil Surgeon will give you the Medical Exam in a Sealed Envelope. S end this to Attorney Pai by courier like Fedex or UPS.
c. The Civil Surgeon will give you a copy of the Medical Exam for your records. Send this copy to Attorney Pai along with the Sealed Medical Exam.
9. Call or email Attorney Pai with a report of how the Medical Exam went especially if there is a need to file a Form 601 Waiver.
MAKE SURE YOU ALLOT ENOUGH TIME AND MONEY TO COMPLETE THE MEDICAL EXAMINATION. THE COST WILL VARY DEPENDING ON WHAT YOUR INSURANCE COVERS. SOME VACCINATIONS REQUIRE YOU TO RETURN FOR A SECOND OR EVEN THIRD VISIT.