The full INS immigration exam is very simple and requires only 4 basic steps and two office visits:


Basic immigration physical exam and mental status evaluation (exam sometimes may be performed on the second visit)

Blood Test: Applicants age 15 and older are required to have a serologic blood test for HIV (AIDS) and Syphilis (RPR). Applicants under age 15 may require HIV or syphilis testing at the discretion of the civil surgeon, or if there is reason to suspect the possibility of infection. Dr. Cruz will provide pre-test counseling to all applicants who take the HIV test. If you are found to have HIV infection , post-test counseling will be provided also.

Tuberculosis Testing: Please beware that starting October 1, 2018,  the tuberculin skin test (TST) will no longer be accepted for US Citizenship and Immigration Services (USCIS) I-693 Form Report of Medical Examination and Vaccination Record.

All applicants ages 2 and up will now be required to obtain a TB blood test (interferon-gamma release assay or IGRA) as the initial TB screening method.

This new TB blood test will bear the following consequences:

  • Children will be subjected to venipuncture (blood work)
  • There will be an increase in the price of the medical exam
  • The sealed envelope will be ready in 4-5 business days instead of 2 days as previously promised.


Proof of vaccinations or blood Titer to prove immunity. Most adults require proof of vaccination for Tetanus-Diphtheria Td (within the last 5 years), Measles, Mumps, Rubella and Varicella (Chicken Pox). Blood Titer is a test that proves that a person has immunity or antibodies for a particular disease. The Immigration Doctor will review your vaccination history with you to determine whether you have all the required vaccinations. The cost of additional vaccinations is not included in the price of the basic exam but they are offered through our office for an additional fee. Please bring all vaccination records to your scheduled appointment for the immigration physical.

After The Exam

After the immigration physical examination is completed, Dr. Cruz will certify Form I-693 with the test results of the immigration exam and vaccination history in a sealed enveloped to present to the INS. DO NOT OPEN THE SEALED ENVELOPE. Turn in the envelope with your immigration application. A copy of your blood tests results will be provided for you to keep after results have been discussed with the examining doctor. The examination will only be valid up to a year after the immigration exam date.

Click here to visit the Official US Citizen & Immigration Services website for more information.