What Should Parents Know About Immigration Medical Exams for Children?

If your child needs an immigration medical examination, you may have questions about what the appointment involves, what documents you should bring, and whether your child will need vaccines or laboratory testing.

An immigration medical examination is different from a regular pediatric checkup. When required for an immigration application, the examination must be completed according to U.S. immigration medical requirements by a USCIS-designated civil surgeon in the United States. The civil surgeon follows CDC technical instructions when completing the examination and Form I-693.

Here are some important things parents should know before bringing their child to an immigration medical exam.

1. Your Child's Age Matters

Immigration medical requirements are not exactly the same for every child.

The child's age can affect which vaccinations are required and which medical tests may be necessary. The CDC provides age-specific vaccination requirements for children, so parents should not assume that every child needs the same vaccines.

The civil surgeon will review the child's age, medical history, vaccination records, and other relevant information when determining what is needed for the examination.

2. Bring Your Child's Vaccination Records

One of the most important things parents can do is bring all available vaccination records to the appointment.

Vaccination records from another country may be useful if they contain acceptable documentation. The civil surgeon reviews the records and determines whether the child's vaccinations meet the applicable requirements.

If your child is not up to date on an age-appropriate required vaccine, the civil surgeon may recommend or administer the appropriate vaccine according to the current requirements.

Tip for parents: Don't leave old vaccination records at home just because they are from another country. Bring everything you have.

3. Children May Need Tuberculosis Screening

Tuberculosis (TB) screening is an important part of the immigration medical examination.

Under current CDC instructions, children age 2 and older must have an IGRA blood test as part of the immigration medical examination. Children younger than 2 generally have a different process, unless there are specific concerns such as signs or symptoms of tuberculosis or known HIV infection.

If an IGRA test is positive, or if certain other circumstances apply, additional evaluation—including a chest X-ray—may be required.

Parents should therefore not assume that a child is too young for any TB screening. The requirements depend on the child's age and medical circumstances.

4. The Medical Exam Is More Than Just a Physical

The immigration medical examination includes a medical history and physical examination.

For children, the medical history may involve information provided by a parent or responsible adult who knows the child well. The civil surgeon may ask about the child's health history, symptoms, previous illnesses, and other relevant medical information.

Parents should provide accurate information and let the civil surgeon know about any important medical history or concerns.

5. Not Every Child Needs the Same Laboratory Tests

Parents sometimes worry that their child will automatically need extensive blood testing.

The required testing depends on the child's age and individual circumstances.

For example, current CDC instructions require syphilis testing for applicants ages 18 through 44. Applicants younger than 18 generally require syphilis testing only when there is a reason to suspect infection. Gonorrhea testing is required for applicants ages 18 through 24, while those younger than 18 are tested when there is a reason to suspect infection.

This means that younger children do not automatically receive the same laboratory testing required for adults.

6. Tell the Civil Surgeon About Your Child's Medical History

Parents should be prepared to provide information about their child's medical history.

This may include:

• Previous illnesses
• Significant medical conditions
• Previous surgeries or hospitalizations
• Current medications
• Important medical records
• Vaccination history
• Previous tuberculosis testing or treatment, if applicable
• Relevant medical documentation from another country

Providing complete information can help the civil surgeon accurately document the examination.

7. Bring Important Documents to the Appointment

Before the appointment, parents should ask the civil surgeon's office what documentation is required.

Depending on the child's situation, useful documents may include:

• Child's passport or government-issued identification
• Vaccination records
• Medical records
• Previous laboratory or TB records, if applicable
• Immigration-related paperwork requested by the medical office
• Any other documentation specifically requested by the civil surgeon

Having documents organized ahead of time can help make the appointment easier.

8. The Civil Surgeon Completes the Medical Documentation

The civil surgeon is responsible for completing the required medical examination documentation.

For applicants completing Form I-693, the civil surgeon records the appropriate medical examination and vaccination information and provides the completed form according to USCIS requirements. The civil surgeon does not make the final immigration decision; immigration authorities make decisions about eligibility after reviewing the case and relevant documentation.

A Helpful Checklist for Parents

Before your child's immigration medical examination, consider preparing:

☐ Vaccination records
☐ Passport or photo identification
☐ Medical records
☐ Current medication information
☐ Previous TB test results, if applicable
☐ Documentation from your child's home country
☐ Any paperwork requested by the civil surgeon's office

Final Thoughts for Parents

Preparing your child for an immigration medical examination does not have to be overwhelming.

The most helpful steps are to bring your child's vaccination records, gather important medical documents, provide accurate medical history, and ask questions if you are unsure about what is required.

Because requirements can depend on your child's age and individual circumstances, it is important to work with a USCIS-designated civil surgeon who follows the current CDC technical instructions.