Registry Provision Overview

The registry provision of the Immigration and Nationality Act (INA Section 249) allows certain individuals who have been continuously residing in the United States since before January 1, 1972, to apply for lawful permanent residence. Registry applicants must demonstrate continuous residence, good moral character, and admissibility.

Registry applicants file Form I-485 to adjust status to permanent residence. As part of this process, they must complete an immigration medical examination.

Medical Exam Requirement

All I-485 applicants, including registry applicants, must complete an immigration medical examination with a USCIS-designated civil surgeon and submit Form I-693. The medical exam requirement applies regardless of how long you have been in the United States.

Registry applicants who have been in the United States for 50 or more years may have limited vaccination records from their home countries. The civil surgeon will review available records and administer any missing required vaccines.

What the Exam Covers

The immigration medical exam covers a complete physical examination, tuberculosis testing, required laboratory tests, and a vaccination review. The civil surgeon will administer any missing required vaccines.

There are no special medical requirements for registry applicants. The exam is the same as for any other I-485 applicant.

Age Considerations for Registry Applicants (Often Seniors)

Registry applicants who have been in the United States since before 1972 are typically elderly — often in their 70s, 80s, or older. The immigration medical exam is adapted for older applicants. Age-appropriate vaccine requirements apply, and the civil surgeon will take into account any chronic health conditions.

Older applicants may have age-related health conditions that are documented on Form I-693. Having a chronic health condition does not automatically disqualify you from obtaining a green card.

Vaccination Requirements for Older Applicants

Older applicants may have different vaccine requirements than younger applicants. For example, the shingles vaccine (Zoster) is recommended for adults 50 and older. The pneumococcal vaccine is recommended for adults 65 and older. The civil surgeon will apply age-appropriate vaccine requirements.

Many older applicants received childhood vaccines decades ago and may not have records. The civil surgeon can perform titer tests to check for immunity before administering vaccines.

Practical Tips

Bring any vaccination records you have, including records from your home country and from U.S. healthcare providers. If you have chronic health conditions, bring a list of your medications and any relevant medical records. If you need mobility assistance, contact the civil surgeon's office in advance.