H-4 Dependent Status and Green Card

H-4 visa holders are the spouses and unmarried children under 21 of H-1B visa holders. When the H-1B principal's I-140 immigrant petition is approved and a visa number becomes available, both the H-1B principal and H-4 dependents can file Form I-485 to adjust status to permanent residence.

H-4 dependents file as derivative beneficiaries on the H-1B principal's immigrant petition. Each family member — including the H-1B principal, H-4 spouse, and H-4 children — must file their own I-485 and complete their own medical exam.

Each Family Member Needs Their Own Exam

A common misconception is that family members can share a single Form I-693. This is not correct. Each person filing Form I-485 must complete their own immigration medical examination and submit their own sealed Form I-693. There are no exceptions to this rule.

The civil surgeon will complete a separate I-693 for each family member, sealed in a separate envelope. Each envelope must be submitted with the corresponding family member's I-485 application.

What the Exam Covers for H-4 Dependents

The immigration medical exam for H-4 dependents covers the same components as for any other I-485 applicant: a complete physical examination, tuberculosis testing, required laboratory tests (for applicants age 15 and older), and a vaccination review.

Age-appropriate requirements apply. Children under 15 do not need syphilis or gonorrhea testing. Children under 2 have different TB testing requirements. The civil surgeon will apply the appropriate requirements based on each family member's age.

Children on H-4 and Age-Specific Requirements

Children on H-4 visas who are filing I-485 must complete an age-appropriate immigration medical exam. Children under 15 do not need syphilis or gonorrhea testing. Children under 2 may have different TB testing protocols.

Vaccine requirements are also age-dependent. The civil surgeon will review each child's vaccination records and administer any missing age-appropriate vaccines. Bring all vaccination records, including records from the child's home country.

Coordinating Family Appointments

Scheduling all family members on the same day is the most efficient approach. At ImmigrationMedicalExams.com, we accommodate family groups and can see multiple family members in a single visit. Call 714-760-4538 to schedule a family appointment.

Bring all family members' vaccination records, passports, and any relevant medical records to the appointment. Having complete records can reduce the number of vaccines needed and speed up the process.

Timing With H-1B Principal's I-485

H-4 dependents should schedule their medical exams at the same time as the H-1B principal. All family members' I-485 applications are typically filed together, so having all I-693 forms ready at the same time is the most efficient approach. Schedule 2 to 4 weeks after the I-485 receipt notices arrive.