When applying for a green card in the United States, one of the critical steps in the process is completing a medical examination, which includes the Form I-693 (Report of Medical Examination and Vaccination Record). This form is required by the U.S. Citizenship and Immigration Services (USCIS) and documents the results of the medical examination, including tests for certain infectious diseases and vaccinations. One of the key aspects of the medical exam involves a series of blood tests, which are designed to ensure that applicants do not pose a public health risk and meet the health-related requirements for immigration.
The blood tests required for the I-693 medical examination typically focus on detecting certain sexually transmitted infections (STIs) and tuberculosis (TB). The exact tests required depend on the applicant’s age and medical history, but include screening for syphilis, gonorrhea, and tuberculosis.
1. Tuberculosis (TB) Test
Tuberculosis (TB) is a bacterial infection that primarily affects the lungs, but it can spread to other parts of the body. TB testing is required for all applicants seeking a U.S. green card as part of the immigration medical examination. The Tuberculosis test is always a blood test and an essential part of the exam.
For applicants aged 2 and older, the USCIS requires a TB blood test (interferon-gamma release assay, or IGRA) which can be a T-spot or a QuantiFERON Gold Test.
- USCIS requires a chest X-ray if the TB skin test or blood test is positive to rule out active tuberculosis disease.
If patients have a positive TB blood test and a negative chest X-ray, they may have latent TB. Most patients with latent TB are not symptomatic. They are often not aware of the previous exposure. Latent or active TB requires follow treatment and often referral to a local health department.
2. Syphilis Blood Test
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. It is a reportable disease, and the U.S. government requires that all applicants for a green card be tested for syphilis.
- Required for applicants aged 18-44 years old.
- The most common test for syphilis is a Treponemal Antibody, RPR (Rapid Plasma Reagin) or VDRL (Venereal Disease Research Laboratory) test, which detects antibodies to the syphilis-causing bacteria.
A positive test for syphilis would be followed by further diagnostic testing to determine whether the person has active syphilis, and if so, treatment would be required before proceeding with the green card application.
3. Gonorrhea Blood Test
Gonorrhea is another sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. While gonorrhea testing is typically a urine test or swab test rather than a blood test, it is required as part of the green card medical examination for certain age groups.
- Required for applicants aged 18-24 years old.
The gonorrhea test screens for the infection in genital, anal, and throat areas, depending on the applicant’s sexual history. If an applicant tests positive for gonorrhea, they must be treated with antibiotics before continuing with the green card application process.
4. Other Medical Considerations
Aside from these specific blood tests, applicants may also need to show proof of certain vaccinations and undergo additional screening, depending on their medical history and risk factors. These vaccinations and tests are typically documented on the vaccination record portion of the I-693 form. Common vaccinations required include those for measles, mumps, rubella (MMR), varicella (chickenpox), hepatitis B, influenza, polio, Covid and diphtheria, tetanus, and pertussis (DTaP).
Additionally, any medical conditions or disabilities discovered during the examination may also be reported, though they are not automatically disqualifying factors unless they are considered a public health risk.
Conclusion
The I-693 medical examination is an essential part of the immigration process for anyone seeking to obtain a U.S. green card. Blood tests for tuberculosis, syphilis, and gonorrhea are mandatory for applicants based on their ages, with additional screening required if any of these tests come back positive. TB testing is a critical part of ensuring that individuals do not pose a public health risk and required for all patients.
It is important for applicants to undergo the I-693 examination with a designated civil surgeon, who will ensure that all required tests are administered, and the results are properly documented.
Dr. Haymore and his team can guide you personally through the process of completing your green card or immigration physical. He has completed hundreds of exams and is well versed in the USCIS requirements. Your care is not passed off to midlevel provider or physician extender. You work with a board-certified Civil Surgeon the entire process. Schedule an immigration physical with us today and let our experienced Civil Surgeon guide you!