I-485 Medical Exam in Ontario: Immigration Physical Requirements Guide

Quick Answer

Ontario, California, a major Inland Empire city with a population exceeding 180,000, is home to a growing Arab community with families from Iraq, Syria, Lebanon, Egypt, and other Middle Eastern and North African nations. Many Ontario residents are in the process of adjusting their immigration status and need to complete the mandatory medical examination. SoCal Immigration Services provides Arabic-speaking guidance to Ontario applicants navigating the I-693 medical exam requirements, helping families find civil surgeons and prepare for this critical step in the green card process.

Reviewed for accuracy by

Maria Santos

DOJ Accredited Representative • 15+ years experience

I-693 Medical Exam Overview: What You Need to Know

The immigration medical examination, documented on Form I-693 (Report of Medical Examination and Vaccination Record), is a mandatory requirement for virtually all I-485 Adjustment of Status applicants. This exam ensures that applicants do not have any health conditions that would make them inadmissible to the United States under INA Section 212(a)(1).

The medical exam must be performed by a civil surgeon — a physician designated by USCIS who has completed special training in immigration medical requirements. Regular doctors, including your primary care physician, cannot perform the immigration medical exam unless they are specifically designated as civil surgeons.

The purpose of the exam is to identify: Class A conditions that make an applicant inadmissible (active tuberculosis, certain STDs that are untreated, physical or mental disorders with harmful behavior, and drug abuse or addiction); Class B conditions that do not make an applicant inadmissible but are noted for follow-up; and vaccination deficiencies that must be corrected before the green card can be approved.

The I-693 form is completed by the civil surgeon, sealed in an envelope, and provided to the applicant. You submit this sealed envelope with your I-485 application or bring it to your adjustment interview. USCIS will reject an I-693 that has been opened by the applicant.

Finding a USCIS-Designated Civil Surgeon in Ontario

Locating a qualified civil surgeon near Ontario is the first step. USCIS maintains an online directory of designated civil surgeons that you can search by zip code or city.

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Step 1: Search the USCIS Civil Surgeon Locator
Visit the USCIS website at uscis.gov and use the 'Find a Doctor' tool. Enter your Ontario, CA zip code (91761, 91762, 91764) or nearby zip codes to find civil surgeons in the area. The tool shows the doctor's name, address, phone number, and languages spoken. Look for civil surgeons who speak Arabic if language is a concern.
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Step 2: Verify the Doctor's Designation Is Current
Civil surgeon designations expire and must be renewed. When you call to schedule an appointment, confirm that the doctor's USCIS designation is currently active. An exam performed by a doctor whose designation has expired will be rejected by USCIS. Ask the office to confirm their current designation status.
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Step 3: Ask About Fees and What Is Included
Civil surgeon fees in the Ontario/Inland Empire area typically range from $150 to $400 for the exam, with vaccinations charged separately. Ask whether the fee includes the physical exam, TB test, blood work, and I-693 form completion. Some offices charge separately for each component. Vaccinations can add $100 to $500+ depending on which ones you need.
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Step 4: Schedule the Appointment
Book your appointment at least 2 to 4 weeks before you need the completed I-693. Some civil surgeons can complete the entire exam in one visit, while others require two visits — one for the initial exam and TB skin test placement, and a second visit 48-72 hours later to read the TB test results. If a chest X-ray is needed, additional time may be required.
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Step 5: Prepare for the Appointment
Bring your passport or government-issued photo ID, vaccination records from your home country (translated to English if necessary), any previous medical records relevant to the exam, a list of current medications, and the I-693 form (you can download it from uscis.gov and fill in Part 1 with your biographical information before the appointment). Wear comfortable clothing as the exam includes a physical evaluation.

Components of the Immigration Medical Exam

The I-693 medical exam is thorough and covers several areas required by USCIS regulations. Understanding what to expect helps Ontario applicants prepare and reduces anxiety about the process.

•Physical Examination: The civil surgeon performs a comprehensive physical exam including height, weight, blood pressure, vision, hearing, heart and lung evaluation, and examination of the skin, head, neck, abdomen, lymph nodes, and extremities
•Mental Health Evaluation: The doctor assesses your mental health through a clinical interview and observation. This evaluates whether you have a physical or mental disorder associated with harmful behavior. A history of mental health treatment does not automatically disqualify you
•Tuberculosis (TB) Screening: All applicants aged 2 and older receive a TB skin test (Mantoux/PPD) or IGRA blood test. If the skin test is positive (10mm+ induration), a chest X-ray is required. If the X-ray shows abnormalities, sputum cultures may be needed. A positive TB test does not mean denial — latent TB is a Class B condition, not a disqualifier
•Syphilis and Gonorrhea Screening: Blood test for syphilis (RPR or VDRL) is required for applicants aged 15 and older. Gonorrhea testing may be required based on the applicant's risk factors and symptoms
•Vaccination Review: The civil surgeon reviews your vaccination history against the USCIS-required vaccination list and administers any missing vaccines or documents a medical waiver if vaccines are contraindicated
•Drug and Alcohol Screening: The civil surgeon evaluates for substance abuse or addiction through a clinical interview. A urine drug screen may be performed if clinically indicated. A history of drug use does not automatically lead to inadmissibility — current abuse or addiction is the standard

Vaccination Requirements for the I-485 Medical Exam

USCIS requires applicants to be up to date on specific vaccinations as part of the I-693 medical exam. The required vaccines are determined by the CDC Advisory Committee on Immunization Practices (ACIP) and include age-appropriate vaccines.

Vaccine	Who Needs It	Doses Required	Notes
MMR (Measles, Mumps, Rubella)	All applicants born in or after 1957	2 doses	Blood titer can substitute if immunity is proven
Tetanus/Diphtheria (Td or Tdap)	All applicants	Primary series + booster	Tdap required once; Td booster every 10 years
Polio (IPV)	Applicants under 18	4 doses	Adults generally exempt unless incomplete series
Hepatitis B	Applicants under 18; recommended for adults	3 doses	Blood titer showing immunity can substitute
Varicella (Chickenpox)	All applicants without evidence of immunity	2 doses	History of chickenpox with doctor documentation accepted
Influenza (Flu)	All applicants during flu season	1 dose annually	Required October through March only
COVID-19	All applicants 6 months+	Per current ACIP schedule	Check current USCIS guidance for requirements
Hepatitis A	Applicants 12-23 months	2 doses	Generally not required for adults
Pneumococcal	Children under 5; adults 65+	Per ACIP schedule	Age-specific requirements apply
Rotavirus	Infants only	2-3 doses	Only for infants under 8 months

I-693 Validity Period and Timing Strategy

The timing of your medical exam is critical because the I-693 has a limited validity period. Understanding the rules prevents the costly and inconvenient situation of having to repeat the exam.

As of the current USCIS policy, Form I-693 is valid for 2 years from the date the civil surgeon signs it. USCIS must make a decision on your I-485 application within this 2-year window for the I-693 to be accepted. If your I-485 takes longer to adjudicate, you may need a new medical exam.

The civil surgeon can sign the I-693 no more than 60 days before you file Form I-485. If the I-693 is signed more than 60 days before I-485 filing, USCIS will reject it. This means you should complete your medical exam no earlier than 60 days before your planned I-485 filing date.

For Ontario applicants, the optimal strategy is to schedule your medical exam 2 to 4 weeks before your planned I-485 filing date. This gives you enough time to complete the exam (including any follow-up for TB testing or vaccinations) while staying well within the 60-day window.

If you have already filed I-485 without the I-693, you can submit it later. USCIS allows you to bring the sealed I-693 to your adjustment interview or submit it in response to a Request for Evidence (RFE). The 60-day pre-filing restriction only applies if you submit the I-693 together with the I-485.

•I-693 is valid for 2 years from the civil surgeon's signature date
•If submitting with I-485: civil surgeon must sign no more than 60 days before filing
•If submitting after I-485 filing: the 60-day rule does not apply
•Schedule your exam 2-4 weeks before your planned I-485 filing
•Keep the sealed I-693 envelope in a safe place — do not open it
•If your I-485 has been pending for over 18 months, check whether a new I-693 will be needed

Common Issues and How to Avoid Them

Ontario applicants frequently encounter issues with the I-693 medical exam that can delay their green card cases. Knowing these pitfalls in advance helps you avoid them.

•Missing vaccination records: Many Arab immigrants do not have childhood vaccination records from their home countries. If records are unavailable, the civil surgeon can perform blood titers (immunity tests) for certain vaccines or re-administer vaccines. Bring any records you have, even if incomplete
•Positive TB skin test: Arab immigrants from countries with high TB prevalence often test positive on the TB skin test. This does not mean you have active TB — a positive skin test is common and usually indicates latent TB. A chest X-ray will be ordered, and if clear, you receive a Class B waiver notation that does not affect your green card
•Opening the sealed envelope: The I-693 must remain sealed. If you open it out of curiosity, the civil surgeon must complete a new form and seal it again (additional fee applies). USCIS will reject an opened I-693
•Expired I-693: If your I-485 processing takes longer than expected and the I-693 expires, you must get a new medical exam. Monitor your case timeline and plan accordingly
•Using a non-designated doctor: Only USCIS-designated civil surgeons can perform the immigration medical exam. An exam performed by any other doctor, including your regular physician, will be rejected
•Incomplete vaccination series: Some vaccines require multiple doses over several months (Hepatitis B requires 3 doses). If you need a multi-dose series, the civil surgeon can still sign the I-693 and document the outstanding doses, but you must complete the series and provide proof to USCIS
•Name discrepancies: Ensure your name on the I-693 matches exactly as it appears on your I-485. Arab names with transliteration variations (e.g., Mohammed vs. Muhammad) can cause processing delays

Timeline and Costs for the Immigration Medical Exam

Understanding the full cost of the immigration medical exam helps Ontario families budget for this required step in the green card process.

Item	Estimated Cost	Timeline	Notes
Civil surgeon exam fee	$150-$400	1-2 visits	Includes physical, mental health eval, I-693 completion
TB skin test (PPD/Mantoux)	$20-$50	48-72 hours for reading	Included in some exam fees
TB blood test (IGRA/QuantiFERON)	$50-$150	3-5 days for results	Alternative to skin test
Chest X-ray (if TB positive)	$75-$200	Same day or next day	Required only for positive TB screening
Blood tests (syphilis, titers)	$50-$150	1-3 days for results	Required for syphilis; titers if missing records
Vaccinations (per vaccine)	$25-$150 each	Administered at exam visit	Varies by vaccine; flu shot often cheapest
Total estimated range	$200-$900+	1-3 weeks total	Higher end if multiple vaccines needed

Why Choose SoCal Immigration Services in Ontario

Arab families in Ontario choose our team for immigration medical exam guidance because we simplify this complex requirement:

•Arabic-speaking staff who explain the medical exam process and help you understand what to expect
•Referrals to trusted civil surgeons in the Ontario/Inland Empire area, including Arabic-speaking doctors when available
•Assistance gathering and organizing vaccination records from Middle Eastern and North African countries
•I-693 review before submission to catch errors that could delay your green card case
•Coordination between the medical exam timeline and your I-485 filing strategy
•Guidance on vaccination waivers for religious or medical exemptions when applicable
•Serving Ontario, Rancho Cucamonga, Fontana, Upland, Pomona, and all of the Inland Empire
•Free initial consultation to plan your medical exam timeline and answer your questions

Contact SoCal Immigration Services

For immigration medical exam guidance in Ontario, California, contact SoCal Immigration Services today. Call (714) 421-8872 to schedule a free consultation with our Arabic-speaking team. We help Arab families in Ontario, Rancho Cucamonga, Fontana, Upland, and all of the Inland Empire navigate the I-693 medical exam requirement and complete their I-485 adjustment of status applications successfully. Do not let the medical exam become an obstacle — let us guide you through every step.

FAQFrequently Asked Questions

Q:How much does the immigration medical exam cost in Ontario?

A: The immigration medical exam in the Ontario/Inland Empire area typically costs $150 to $400 for the civil surgeon's exam fee. Additional costs include vaccinations ($25-$150 per vaccine), blood tests ($50-$150), and a chest X-ray if needed ($75-$200). Total costs range from $200 to $900+ depending on your vaccination needs.

Q:How long is the I-693 medical exam valid?

A: Form I-693 is valid for 2 years from the date the civil surgeon signs it. USCIS must adjudicate your I-485 within this 2-year window for the I-693 to be accepted. If your case takes longer, you will need to repeat the medical exam and obtain a new I-693.

Q:What if I tested positive for TB in the past?

A: A positive TB skin test is very common among immigrants from Middle Eastern and North African countries and does not mean you have active TB. If your TB skin test is positive, the civil surgeon will order a chest X-ray. If the X-ray is normal, you will receive a Class B notation on your I-693, which does not affect your green card eligibility. Only active, untreated TB is a Class A disqualifying condition.

Q:Can I use my own doctor for the immigration medical exam?

A: Only if your doctor is a USCIS-designated civil surgeon. Regular physicians cannot perform the immigration medical exam. Use the USCIS 'Find a Doctor' tool at uscis.gov to locate a designated civil surgeon near Ontario. The doctor must have current USCIS designation to perform the exam.

Q:What if I do not have my vaccination records from my home country?

A: If you cannot obtain vaccination records, the civil surgeon can perform blood tests (titers) to check your immunity for certain vaccines like MMR, Hepatitis B, and Varicella. If titers show immunity, you do not need the vaccine. If titers are negative or records are unavailable, the civil surgeon will administer the required vaccinations at the appointment.

Q:Do I need the medical exam if I am already in the U.S. on a valid visa?

A: Yes. The I-693 immigration medical exam is required for all I-485 adjustment of status applicants regardless of your current visa status. Even if you had a medical exam for your original visa, you need a new exam performed by a USCIS-designated civil surgeon for the I-485.

Q:Can I get a vaccination waiver for religious reasons?

A: Yes. USCIS allows religious or moral conviction waivers for vaccination requirements. You must submit a signed statement explaining your religious or moral objection to vaccines, along with Form I-601 (Application for Waiver of Grounds of Inadmissibility). The waiver is discretionary and not guaranteed. Consult an immigration attorney before relying on a waiver strategy.

Q:What happens if USCIS rejects my I-693?

A: If USCIS rejects your I-693 due to errors, expiration, or other issues, they will typically issue a Request for Evidence (RFE) giving you time to submit a corrected or new I-693. Common reasons for rejection include: the form was opened, the civil surgeon's designation was expired, the I-693 validity period expired, or there are significant errors or missing information. Respond promptly to any RFE to avoid delays.

Disclaimer: This article provides general information about immigration services in Ontario and does not constitute legal advice. SoCal Immigration Services is a document preparation company, not a law firm. For legal advice specific to your situation, please consult with a licensed immigration attorney.

Published: February 22, 2026Last Updated: February 22, 2026

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