Start With Vaccination Records — For Everyone

If there is one thing you do before your family's immigration medical appointment, make it this: gather vaccination records for every single family member. Vaccination history is the foundation of the Form I-693 evaluation, and missing or incomplete records are the most common reason appointments run long or require follow-up visits.

Valid vaccination records include official immunization cards, printed records from a pediatrician or primary care provider, state immunization registry printouts, and school health records. Digital records from a patient portal are also acceptable when they clearly identify the patient, the vaccine administered, and the date given.

Foreign vaccination records are accepted. If your family's records are in another language, bring them anyway — our civil surgeon is experienced in reviewing international immunization documents, and a translation is helpful but not always required for standard vaccines. If you have any doubt, a certified translation can be obtained quickly and inexpensively.

If records are missing entirely, do not cancel your appointment. Come in with whatever you have. Our civil surgeon will review what is available and determine whether catch-up vaccines are needed on the day of the exam. Catch-up vaccines can be administered at our clinic, though this may add time and cost to your visit. Contacting your family's primary care provider or your home country's health authority before the appointment is the best way to recover lost records.

Documents Each Family Member Needs

Every family member attending the exam must bring their own documentation. Organizing each person's documents in a separate labeled folder or envelope before you arrive will save significant time at check-in and reduce stress on exam day.

Here is what each family member needs to bring:

• Adults (18 and older): Valid government-issued photo ID — a passport is preferred, but a driver's license or state-issued ID is also accepted
• Children (under 18): Birth certificate or passport; a parent or legal guardian must also be present
• All ages: All available vaccination records, organized chronologically
• All ages: Any relevant medical records — this includes documentation of chronic conditions, prior tuberculosis (TB) treatment or exposure, mental health history, and records of any surgeries or hospitalizations
• All ages: A list of current medications, including dosages (especially important for seniors and anyone with ongoing treatment)

Preparing Children for the Exam

Children often feel anxious about medical appointments, especially when they don't know what to expect. Taking a few minutes to explain the process in age-appropriate terms before your appointment can make a meaningful difference in how smoothly things go.

Let younger children know that a doctor will check how healthy they are — similar to their regular check-up — and that they may get a shot to help keep them healthy. Avoid framing vaccines as something to fear; instead, emphasize that it is quick and that the doctor and nurses are there to help.

For older children and teenagers, a straightforward explanation works best: the doctor will ask some health questions, check their height, weight, vision, and hearing, and review their vaccination records. They may need a blood draw or a TB skin test.

A parent or legal guardian must be present throughout the examination of any minor. Bringing a comfort item — a stuffed animal, a favorite book, or a small toy — can help younger children stay calm during the wait. Children under 15 years of age do not require a chest X-ray as part of the immigration medical exam. TB testing for children is typically done via a tuberculin skin test (TST) or, in some cases, a blood draw (IGRA test).

Preparing Seniors in the Family

Older family members often have more complex medical histories, which means a little extra preparation goes a long way. Before the appointment, compile a complete and current medication list for every senior in your family, including the name of each medication, the dosage, and how often it is taken. This list helps the civil surgeon complete the medical history portion of Form I-693 accurately and efficiently.

Bring documentation of any chronic conditions — diabetes, hypertension, heart disease, COPD, or any other ongoing health issues. If a senior family member has a history of tuberculosis exposure or treatment, bring those records specifically, as TB evaluation is a required component of the exam.

A chest X-ray is required for all applicants 15 years of age and older. Our clinic is equipped to perform this on-site. If a senior family member has mobility limitations or requires accommodations, please let our office know when scheduling — we are happy to make arrangements to ensure a comfortable visit.

Some vaccines may not be required for older applicants depending on age and prior vaccination history. Our civil surgeon will review each senior's records individually and determine what, if anything, is needed.

Coordinating Vaccination Records Across the Family

When preparing for a family appointment, it helps to treat each person's vaccination records as a separate project. Go through each family member's records individually and note any vaccines that appear to be missing or incomplete based on the USCIS-required vaccination schedule.

If you identify gaps, contact your family's primary care provider before the appointment. Many providers can pull immunization records from state registries or their own systems and provide a printed summary. If records from another country are needed, contact the relevant health authority or the provider who administered the vaccines.

Do not cancel or postpone your appointment simply because some records are incomplete. Our civil surgeon can work with what you have, advise on what is missing, and administer catch-up vaccines at the clinic if necessary. Coming in with partial records is always better than delaying the process.

What to Expect on Exam Day for Families

Plan to arrive 10 to 15 minutes before your scheduled appointment time. This gives your family time to check in, complete any remaining paperwork, and get settled before the examinations begin.

Bring all documents organized by person — separate folders or envelopes for each family member make the check-in process faster and reduce the chance of mixing up records.

Each family member will be called individually for their examination. The civil surgeon evaluates each person separately, which ensures a thorough and accurate assessment for every applicant. Expect each individual exam to take approximately 30 to 60 minutes, depending on the complexity of that person's medical history and vaccination needs.

For a family of three to four people, plan for a total visit of approximately two to four hours. Our staff will coordinate the flow of the appointment to keep things moving efficiently. If you have young children who are waiting, bringing snacks, activities, or a tablet can help pass the time comfortably.

After the Exam: What Happens Next

After each family member's examination is complete, our civil surgeon will prepare a sealed Form I-693 for that individual. Each person receives their own sealed envelope — the forms are not combined into a single family document.

Standard processing takes two to three business days. Expedited processing is available if your timeline requires it — ask our staff when you check in. Do not open the sealed envelope under any circumstances; a broken seal renders the form invalid for USCIS submission.

Each sealed Form I-693 should be submitted with the corresponding family member's Form I-485 (Application to Register Permanent Residence), or brought to that person's USCIS interview. Because each form is independent, family members who are at different stages of the immigration process can submit their forms on their own timeline.