When to Refer Clients for the Medical Exam
The timing of the immigration medical exam relative to the I-485 filing is a strategic decision. Here are the key considerations:
Option 1: Concurrent with I-485 filing
Submit Form I-693 with the I-485 package. This approach can reduce interview wait times and demonstrates proactive case management.
Option 2: At the USCIS interview
Client brings the sealed Form I-693 to the USCIS interview. This is the most common approach and avoids the risk of form expiration if the case is significantly delayed.
Key consideration: Form I-693 is valid for 2 years from the Civil Surgeon's signature date. If your client's case may be delayed beyond 2 years, consider timing the exam to avoid expiration. We can advise on optimal timing for your client's specific situation.
How to Coordinate With Our Office
We work with immigration attorneys throughout Southern California and are set up to make the coordination process as smooth as possible.
Direct attorney line
Call (714) 760-4538 to speak directly with our staff about your client's needs. We can discuss scheduling, documentation requirements, and any special circumstances.
Priority scheduling
We offer priority scheduling for attorney-referred clients with urgent timelines. Call us to discuss availability.
Status updates
We can provide status updates on your client's exam and notify you when the sealed Form I-693 is ready.
Direct communication
With your client's authorization, we can communicate directly with your office about exam findings and next steps.
Referral process
No formal referral agreement required. Simply advise your client to call us and mention your firm, or call us directly to coordinate.
Documentation to Advise Clients to Gather
Advising your clients to gather the following documentation before their appointment will minimize delays, reduce costs, and help prevent RFEs:
Vaccination records are critical: Incomplete vaccination records are the most common source of unexpected costs and delays. Advise clients to contact every healthcare provider, school, pharmacy, and home country health authority to obtain complete records before their appointment.
How to Prevent RFEs Related to the Medical Exam
I-693-related RFEs are almost always preventable. The most common causes and how to prevent them:
Expedited Processing Options
For clients with urgent timelines — upcoming USCIS interviews, expiring prior forms, or time-sensitive case circumstances — we offer expedited processing options.
Same-day appointments
We often have same-day appointment availability. Call our attorney line to check current availability for your client.
Priority lab processing
We can request priority processing for QuantiFERON-TB Gold and other lab tests to expedite results.
Expedited form completion
Once lab results are received, we can prioritize completing and sealing your client's Form I-693.
Direct notification
We will notify you and/or your client immediately when the sealed Form I-693 is ready.
For urgent cases: Call our attorney line at (714) 760-4538 as early as possible. We will do everything we can to accommodate your client's timeline.
Handling Clients With Complex Medical Histories
Clients with complex medical histories — including mental health conditions, substance use history, communicable disease history, or chronic conditions — require careful handling during the immigration medical exam.
Mental health history
Most mental health histories do not affect immigration cases. The Civil Surgeon documents findings accurately and objectively. Advise clients to disclose honestly and completely.
Substance use history
Substance use is assessed clinically. Context and history matter. The Civil Surgeon follows USCIS Technical Instructions for documenting substance use findings.
Prior TB treatment
Clients with prior TB treatment should bring all related medical records. The Civil Surgeon will review and document appropriately.
Communicable disease history
Prior history of communicable diseases (HIV, syphilis, etc.) should be disclosed. Most are not current grounds of inadmissibility. Advise clients to bring relevant medical records.
Vaccine contraindications
Clients with documented vaccine contraindications should bring physician documentation. We will review and process medical waivers appropriately.
For clients with complex histories: Call our attorney line before scheduling to discuss the client's situation. We can advise on what documentation to gather and what to expect during the exam.
Why Attorneys Refer Their Clients to Us
Immigration attorneys throughout Southern California refer their clients to ImmigrationMedicalExams.com because we specialize exclusively in USCIS Form I-693 immigration medical exams — and have since 2007.
- USCIS-designated Civil Surgeon since 2007 — exclusively immigration medical exams
- Always use the current USCIS-approved edition of Form I-693
- Thorough vaccination record review to minimize RFE risk
- All required vaccines stocked and administered on-site
- QuantiFERON-TB Gold testing performed on-site
- Same-day appointments available for urgent cases
- Direct attorney communication with client authorization
- Transparent, all-inclusive flat fee pricing
- Costa Mesa location convenient for Orange County and LA clients
- Consistent, reliable results that attorneys can count on
Frequently Asked Questions
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Medical & Legal Disclaimer: The information on this page is provided for general educational purposes only and does not constitute medical or legal advice. USCIS policies, form requirements, and immigration procedures may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to each client's individual case.