Applying for permanent residency includes an important medical milestone: the immigration medical exam required by U.S. Citizenship and Immigration Services.
At Integra Wellness & Aesthetics, our USCIS immigration medical exams in Jacksonville are performed by Dr. Paul Busse, a bilingual civil surgeon who guides applicants through each step with clarity, compassion, and efficiency. By following the most current USCIS and CDC standards, he supports your adjustment-of-status process while protecting public health.
What Is a USCIS Immigration Medical Exam?
A USCIS immigration medical exam is a structured health screening designed to confirm that an applicant meets federal standards for entering or remaining in the country as a permanent resident. The exam follows detailed CDC Technical Instructions that outline the conditions that must be evaluated, the laboratory testing required, and the vaccination review process.
Although comprehensive, the exam focuses on specific areas connected to public health significance rather than functioning as a general physical exam. Dr. Busse completes all required components, records the findings on Form I‑693, and prepares your sealed packet for submission with your green card application. The goal is to support your immigration journey while delivering the attentive, concierge-level service that defines our practice.
Who Performs the Immigration Exam? (Meet Dr. Paul Busse)
Inside the United States, immigration medical exams must be completed by a USCIS‑designated civil surgeon. Dr. Paul A. Busse, board-certified in Family Medicine and fluent in English and Spanish, holds this designation and conducts all exams personally at Integra Wellness & Aesthetics.
His 21 years of clinical experience shape a patient experience built on thorough evaluation, clear communication, and a welcoming, bilingual environment. Applicants often appreciate the convenience of on‑site labs, the option to complete vaccinations during the appointment, and the rapid turnaround for sealed I‑693 packets. With Dr. Busse, you always meet with the physician who signs your forms, creating a seamless and supportive process from start to finish.
What Is Reviewed on Form I‑693?
Form I‑693, the “Report of Immigration Medical Examination and Vaccination Record,” organizes each component of the exam into specific sections that must be completed according to USCIS standards. During your appointment, Dr. Busse reviews your identity documents, vaccination history, medical background, and any records that help clarify past diagnoses or treatments.
The form also includes the civil surgeon’s findings from the physical exam, laboratory testing, tuberculosis screening, and evaluations related to mental health or substance use. Each page must be completed carefully, signed, and sealed. USCIS accepts the results only when presented in an unopened envelope signed across the seal by the civil surgeon. At Integra Wellness & Aesthetics, patients leave with both a sealed packet for their application and a personal copy for their records.
Common Medical Conditions Screened During the Immigration Exam
USCIS identifies several health areas that require evaluation during immigration screening. These conditions are reviewed because they influence public health policy and immigration eligibility under the Immigration and Nationality Act.
Tuberculosis (TB):
Applicants two years of age and older receive a TB test, typically an IGRA blood test. If the result shows possible infection, a chest X‑ray is performed to clarify the presence of active disease. Active TB is classified as a Class A condition and must be treated before the immigration process can continue.
Syphilis and Gonorrhea:
Adults fifteen and older complete required blood and urine tests. These screenings follow CDC protocols and help identify communicable conditions that require treatment. Treated cases often continue through the process after appropriate documentation.
Hansen’s Disease:
During the physical exam, Dr. Busse assesses for any findings consistent with Hansen’s disease. Though uncommon, any signs require further evaluation with a specialist.
Mental Health Conditions With Associated Harmful Behavior:
The exam includes a confidential discussion about mental health history. Conditions associated with harmful behavior, past or present, may require additional documentation or evaluation.
Substance Use Disorders:
Current substance misuse involving controlled substances can fall into Class A eligibility guidelines. Individuals with past concerns who have completed treatment and are in remission often proceed without difficulty.
Dr. Busse approaches these assessments with respect and sensitivity, focusing on guidance that supports both your well-being and your immigration goals.
Vaccination Requirements for Immigration (2025 CDC Guidelines)
The immigration medical exam includes a comprehensive review of your immunization history. The CDC updates these requirements regularly to align with national public health priorities, and civil surgeons must apply the age‑appropriate guidelines during each evaluation.
Required vaccines include MMR (measles, mumps, rubella), varicella, polio, Tdap, hepatitis B, meningococcal, influenza (seasonal), and several early‑childhood immunizations for younger applicants. COVID‑19 vaccination is no longer required based on the 2025 policy update. If you arrive without records or with incomplete documentation, Dr. Busse can administer the necessary vaccines during your appointment. He may also note medical contraindications or eligibility for blanket waivers when appropriate under CDC rules.
TB Test for Immigration: What to Expect
Tuberculosis testing is a required part of every USCIS immigration medical exam. For adults, the preferred method is the IGRA blood test (Interferon-Gamma Release Assay), either Quantiferon-TB Gold or T-SPOT.TB. These tests offer high accuracy and are more reliable than the traditional skin test, especially for individuals who received the BCG vaccine in their home country.
If the result is positive, Dr. Busse arranges a chest X-ray to determine whether the infection is active. Active TB must be treated before immigration approval. However, a latent TB infection with no symptoms and a clear chest X-ray can usually be documented without affecting admissibility. Integra’s on-site laboratory services simplify this process, helping patients complete the TB screening in a single visit when possible.
What Happens After the Exam?
Once the required tests and evaluations are complete, Dr. Busse fills out Form I-693, signs each section, and prepares your sealed medical packet. This envelope must remain unopened and will be submitted to USCIS either by you or your immigration attorney. Opening the packet invalidates it, so Dr. Busse also provides a full copy for your records.
The sealed packet is valid for two years from the date it is signed, provided your underlying green card application (Form I-485) is still pending. At Integra Wellness & Aesthetics, most patients receive their sealed documentation within three to four business days, allowing for smooth coordination with upcoming biometrics appointments or interviews.
What If You Have a Medical Condition? (Class A vs Class B Conditions)
During the immigration exam, the civil surgeon must determine if any conditions fall under Class A or Class B designations.
- Class A conditions are those that may result in inadmissibility unless treated or waived. These include untreated active TB, certain sexually transmitted infections, or current substance use disorders involving controlled substances. In some situations, applicants may pursue a waiver of inadmissibility through Form I-601, often with help from an immigration attorney.
- Class B conditions are less restrictive. They refer to health issues that do not pose a public health risk but are still noted on the I-693 form. Examples include well-controlled chronic conditions or a history of mental illness with no harmful behavior.
Dr. Busse carefully reviews each patient’s history and offers guidance based on current medical standards. His approach centers on respect, clarity, and collaboration, especially for those navigating sensitive or complex health circumstances.
If your condition requires further attention, Integra’s primary care services can help manage your care in the same supportive setting, ensuring continuity and trust throughout your immigration process.
When to Schedule Your Exam
Timing is important when completing the immigration medical exam. Ideally, schedule your visit 4 to 6 weeks before submitting Form I‑485 or attending your green card interview. This provides time for any necessary vaccines, follow-up testing, or documentation.
Appointments at Integra typically last between 30 to 60 minutes, depending on the applicant’s age and medical history. For families applying together, Dr. Busse can often coordinate appointments to accommodate group scheduling.
Since demand for certified civil surgeon services may increase during certain immigration cycles, early scheduling is recommended. We offer flexible availability and bilingual assistance for applicants who need to meet USCIS timelines confidently.
Inclusive, Bilingual Care for Jacksonville’s Immigration Community
Integra Wellness & Aesthetics proudly serves a diverse community of applicants from across Northeast Florida. As a bilingual, physician-led practice, we provide immigration medical exams that are respectful, efficient, and fully compliant with all USCIS and CDC requirements. Dr. Busse takes time to explain each step in both English and Spanish, offering a calm, informed experience for individuals and families alike.
We also welcome patients from all backgrounds, including those seeking LGBTQ+ affirming care, individuals with past health challenges, or applicants who prefer a clinic that offers both medical expertise and compassionate service under one roof.
Schedule Your Immigration Medical Exam in Jacksonville
Led by Dr. Paul Busse, a USCIS-certified civil surgeon in Jacksonville, Integra Wellness & Aesthetics offers concierge-level immigration exams with on-site labs, rapid results, and bilingual support. Whether you’re preparing for your green card interview or updating a sealed packet, our team ensures a smooth, personalized process without the limitations of rushed or referral-based clinics.
Start your application confidently by scheduling your USCIS immigration medical exam in Jacksonville with Dr. Busse today.
Frequently Asked Questions
Can I bring my own vaccination records to the immigration medical exam?
Yes, you can bring official vaccination records. Dr. Busse reviews them to verify CDC compliance. Missing vaccines may still need to be updated or documented during your appointment to complete Form I-693.
Do immigration medical exams include drug testing?
USCIS exams do not include standard drug panels. However, Dr. Busse must assess for current substance use disorders involving controlled substances, which could affect admissibility under Class A conditions.
Is the immigration exam different for children?
Yes. Children under 15 typically receive fewer lab tests, but still require age-specific vaccines and tuberculosis screening. Dr. Busse adjusts the exam based on age, developmental stage, and CDC guidance.
What should I bring to my USCIS medical exam appointment?
Bring a government-issued ID, vaccination records, prior TB or STD test results (if available), immigration case number, and payment. Integra’s team will guide you on any additional documents based on your case.
Can mental health history affect my green card application?
Mental health conditions only affect admissibility if linked to harmful behavior. Dr. Busse discusses your history respectfully and documents it clearly for USCIS if treatment has been successful or ongoing.