What to bring?

​

• Form I-693, Report of Medical Examination and Vaccination Record, pages 1 and 2. If you filled out the registration form, we will have pages 1 and 2 printed for you. 

• Government-issued photo identification, such as a valid passport or driver’s license.

  • ​Those who are 14 years old or younger: bring identification that shows your name, date and place of birth, and parent’s full name. Possible forms of identification include your birth certificate (with an English translation) or an affidavit.

• Vaccination or immunization records (please see the section on "which vaccines are required?")

• Any past medical documents

• Payment in the form of cash/Zelle, debit, or credit card

• If you are not fluent in English, you will need to bring an interpreter to your appointment. 

 

How much does it cost?

​

• Health insurance plans do not cover these immigration exams because they are considered administrative exams.

• Per person, the cost of the immigration exam is $480 (credit/debit), or $460 (cash/Zelle). This total cost includes:

  • Screening lab tests that are required by USCIS (screening for gonorrhea, syphilis and tuberculosis)

    • Please note: the screening tests must be ordered by a US Civil Surgeon. Results of testing that was ordered by an outside physician are not accepted for immigration purposes.

  • Immigration medical exam

  • Evaluation of immunizations​

  • Completion of the I-693 form by our physician
     

• If you prefer to use your health insurance for the screening lab tests, please specify this when you reserve or schedule your appointment. If you prefer using your insurance to cover the lab tests, the cost of the immigration exam is $450 (credit/debit) or $425 (cash/Zelle). ​

  • We recommend that you check with your insurance plan to ensure that lab tests are covered. Here are the codes you will need:​

    • Quantiferon:

      • CPT code: 86480. Diagnosis code z11.1

    • RPR: 

      • CPT code 86592. Diagnosis code z11.3

    • Gonorrhea NAA:

      • CPT code 87591. Diagnosis code Z11.3​

    • MMR titer:

      • CPT codes 86735, 86762, and 86765. Diagnosis code z01.84

    • Hepatitis B titer: 

      • CPT code 86706. Diagnosis code z01.84

    • Varicella titer:

      • CPT code 86787. Diagnosis code z01.84

​

When can I schedule an appointment?​

​

Appointments are typically available within 1-2 weeks and scheduled during the following times:

• Mondays 10am - 2pm

• Wednesdays 10am - 2pm

• Fridays 10am - 2pm

​

Requests for more urgent appointments will be considered on a case-by-case basis and may incur an extra fee of $50.

​

How do I schedule an appointment?

​

Please fill out this form, then text 971-238-2330 to schedule an appointment:

​

​​​​​​​​​​​

• If we are busy and can’t answer the phone, please leave a message or send a text stating you are interested in scheduling an Immigration Exam and we will reply as soon as possible. 

• If you need to re-schedule your appointment, please give at least 24 hours advance notice. There are no fees for rescheduling.

​

What to expect?

​

• During the first appointment, we will gather information about your identity, vaccinations, and medical history.

• We will also check your weight, height, vital signs, and perform a general physical exam.

• We will then order necessary tests

  • You will go to Labcorp to have your blood drawn, and urine collected (if needed).

• If you are missing required vaccines, we will let you know which ones you need and you can get them at a nearby pharmacy.

• Lab results are usually available within 5-7 days. When we receive the results, we will review them and contact you if there are any concerns.

  • ​If you test positive for any of the screening tests, you may need additional visits for treatment and follow-up. ​There may be additional fees involved if you need additional treatment or testing. 

• If you have a chronic medical condition (such as hypertension or diabetes), you may need to get a supporting letter from your primary care doctor or specialist, and they may need to sign part of the I-693 (page 11). This can add extra time depending on how fast you can request this documentation from your doctor.

• Once all of your labs results have been received (if normal), and you have received your required vaccinations, you will be scheduled to return to the office and pick up your sealed envelope containing the completed I-693 form.

  • You will also receive a copy of the I-693 for your records.

  • Please note: if you are needing a second sealed envelope or a second copy, the fee is $5 per additional envelope. 

​

Which vaccines are required?

​

See Table 1: https://www.cdc.gov/immigrant-refugee-health/media/pdfs/Vaccine-Requirements-According-to-Applicant-Age-civil-surgeons-p.pdf

 

For most healthy adults under age 65, the following are required:

​

• One dose of the Tetanus, Diptheria, and Pertussis (Tdap) vaccine within the last 10 years if you have received primary vaccination series for tetanus, dipthteria, and pertussis.

  • Those who have not completed the primary series will need at least one dose, if it is due at the time of the exam.

    • 3 dose series: 1 dose Tdap, followed by 1 dose Td or Tdap at least 4 weeks later, and a third dose of Td or Tdap 6–12 months later.

​

• 3 doses of the Polio (OPV/IPV) vaccine

  • Adults who have not completed the primary vaccine series will need at least one dose, if it is due at the time of the exam.

    • 3 dose series with at least 4 weeks between Dose 1 and 2 and 6 months between Dose 2 and 3).

  • The last dose of the polio series must be given at age 4 or older.​

​

• 2 to 3 doses of the Hepatitis B vaccine. 

  • If you are unvaccinated against Hepatitis B, you will need to get at least one dose, if it is due at the time of the exam.

    • ​2 dose series Heplisav-B
      • At least 4 weeks between Dose 1 and 2 

    • 3 dose series Engerix-B, PreHevbrio, or RecombivaxHB

      • At least 4 weeks between Dose 1 and 2, 8 weeks between Dose 2 and 3, and 16 weeks between Dose 1 and 3

    • 3 dose series HepA-HepB (Twinrix)

      • At least 4 weeks between Dose 1 and 2, 5 months between Dose 2 and 3, and 6 months between Dose 1 and 3

    • Heplisav-B and PreHevbrio are not recommended in pregnancy due to lack of safety data in pregnant persons

  • If you think you may have received Hep B vaccinations but don’t have your vaccine record, you can request an extra blood test to check for immunity against Hepatitis B (extra cost of $16).

​

• 2 doses of the Measles, Mumps, and Rubella (MMR) vaccine. 

  • If you are unvaccinated against these, you will need to get at least one dose in order to meet the requirement. The second dose should be completed at least 4 weeks after the first dose.

    • If there is a chance you could be pregnant, take a pregnancy test before receiving the varicella vaccine because this is a live vaccine.

  • If you think you received these vaccines but don’t have your vaccine record, you can request an extra blood test to check for immunity against these (extra cost of $16).

​

• 2 doses of the varicella (chickenpox) vaccine OR a history of having chickenpox/varicella in the past. 

  • If you are uncertain whether you had chickenpox or got the vaccine, an extra blood test can be done to check for immunity (extra cost of $16).

    • If there is a chance you could be pregnant, take a pregnancy test before receiving the varicella vaccine because this is a live vaccine.

  • If you never had chickenpox and are unvaccinated, you will need to get one dose in order to meet the requirement.

    • If you are over 50, you may be required to have the shingles vaccine, which is a particular version of the varicella vaccine for older adults.

​

• One dose of the current season Covid-19 vaccine (2024-2025 booster available in Sept 2024).

​

• One dose of the current seasonal influenza vaccine if it is flu season (Sept 1 - March 31).

 

For adults 65 and older, or adults with chronic health conditions, additional vaccines may be required, including a pneumonia vaccine (PCV20).

​

For children/teens, the list is much longer and may include vaccines depending on age: 

• DTaP, Polio, Hib, PCV, Rotavirus, Hepatitis A, and Meningococcus.

 

What if I don’t have any vaccine records?

 

Extra blood tests can be ordered to check for immunity against certain diseases, including hepatitis B, measles, mumps, rubella, and varicella (chickenpox). The Hep B, varicella, and MMR titers cost $16 each. 

​

For all other vaccines, if you do not have documentation, you will have to receive at least one dose of each vaccine.

​

What if my records are not in English?

​

For records in any language other than English, you need to pay a professional to provide a certified translated copy and bring this to your first appointment. You can search for these services online.

​

Where can I get the vaccines I need?

​

If you have health insurance, you can get the vaccines at any pharmacy or your primary care doctor's office.​

 

If you do NOT have health insurance, you can try these options:​​

• Outside In (clinic in Portland) - cost may depend on your income or ability to pay.

• Planned Parenthood - they offer Hep B, COVID and flu vaccines at reduced cost.

• Multnomah County Health clinics

• Costco pharmacy if you have Costco membership

• Goodrx has coupons for these vaccinations at select pharmacies:

  • MMR, Boostrix (Tdap), Heplisav-B (Hep B), Ipol (Polio), Varivax (Varicella).

• If you are a student, school based health centers can give immunizations

  • Washington County school based health centers: Beaverton HS, Century HS, Forest Grove HS, Merlo Station HS, Tigard HS, Tualatin HS)​

​

​Be sure to ask for a receipt that includes the name of the vaccine(s), the date of administration, etc.

​

What if I object to vaccination?

​

You need to obtain a blanket vaccine waiver through USCIS. You can still complete the medical exam and get the completed I-693 form, but I must check the box: “Applicant will request an individual waiver based on religious or moral convictions.”

• Whether your waiver is approved by USCIS or not is completely up to USCIS. If your waiver is declined, you may need to pay to complete the process again.

​

Which lab tests are required?

​

USCIS requires testing for the following:

• Tuberculosis (blood test) for anyone 2 years and older

• Syphilis (blood test) for adults ages 18-44

• Gonorrhea (urine test) for adults ages 18-24​

​

How long does it take to get the completed I-693 form?

​

​If you complete all of your vaccinations on time, AND all of your lab results are normal, then the process typically takes one week.

• If you have any abnormal test results or a chronic medical condition, or if you are missing vaccines, the process may take longer.

• At the second or final appointment, you will receive the completed I-693 in a sealed envelope and a copy of the completed I-693 for your records.

​

What if I only need the vaccination review completed?

​

You must specify this at the time you make the appointment. The cost of this vaccination record review is $175.

This includes only Parts 1-5 and Part 10 of the I-693 form. It does not include a physical exam, medical history, or screening for communicable diseases.