Prospective Civil Surgeons

OMB Control No. 1615-0114; Expires 7/31/2013

Depending on the immigration benefit sought, an applicant may be required to undergo medical examination. Immigration medical examinations conducted inside the United States must be performed by a civil surgeon who has been designated by USCIS. (Immigration medical examinations conducted outside the United States must be performed by a panel physician who has been designated by the Department of State.)

Professional Qualifications Required to Be a Civil Surgeon

In order to perform immigration medical examinations, you must be a physician designated by USCIS as a civil surgeon. Physicians must meet the following professional qualifications to be designated a civil surgeon:

• Be a medical doctor (M.D.) or doctor of osteopathy (D.O.),
• Be licensed in the state where medical services are rendered,
• Have 4 years of professional experience, not including experience related to training (i.e. internships and residencies), and
• Be authorized to work in the United States.

Civil Surgeons’ Responsibilities

Civil surgeons must perform the immigration medical examination according to the Technical Instructions for the Medical Examinations of Aliens in the United States (Technical Instructions or TIs) and any updates to the Technical Instructions, published by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

The Technical Instructions updates can be obtained from CDC’s website and can also be found on the right side of this page.

CDC does not mail hard copies of these documents; it is the responsibility of the civil surgeon to obtain these documents online and comply with the requirements of the Technical Instructions.

Failure to comply with the Technical Instructions may result in the revocation of civil surgeon designation by USCIS.

Applying for Civil Surgeon Designation

Physicians interested in applying for civil surgeon designation should submit the following to their local USCIS Office:

• A letter to the District Director requesting consideration;
• A copy of a current medical license;
• A current resume that reflects four years of professional experience, not including training-related experience;
• Proof of U.S. Citizenship or lawful status in the United States; and
• Two signature cards with typed name and signature below.

You can find the address of your local USCIS office by using the Local Office Locator.

Burden Disclosure Notice and Privacy Act Statement

An agency may not conduct or sponsor an information collection and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number.  The public reporting burden for the Application for Civil Surgeon Designation Registration is estimated at 60 minutes per response, including the time for reviewing the instructions and completing and submitting the form.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division, Office of Policy and Strategy, 20 Massachusetts Ave, N.W., Washington, D.C., 20529-2020 and include OMB Control Number 1615-0096 for reference.  Please do not mail your completed information collection to this address.

Blanket Designation of Certain Physicians Working at Health Departments

USCIS has the authority to designate individuals or members of an entire group as civil surgeons , provided the physicians meet the legal requirements to be a civil surgeon, as specified in the Immigration and Nationality Act (INA) section 232(b), 8 CFR § 232.2(b), and 42 CFR § 34.2(b).

A memorandum dated July 30, 1998 (HQ 70/21.1.1, 96 Act 074, HQOPRD), designated all state and local health departments as civil surgeons for refugees applying for adjustment of status to ease the difficulties encountered by these applicants when obtaining their vaccination sign-off. This blanket designation does not cover asylees seeking to adjust status under INA section 209 or refugees who are required to have a full medical examination.

Participation in this HQOPRD blanket civil surgeon designation is entirely voluntary and at the discretion of the individual health department. As long as the designated physician meets the requirements of a civil surgeon, the health department may participate by completing the vaccination sheet of Form I-693, Report of Medical Examination and Vaccination Record.  The health department and the physician do not have to apply for the designation.

USCIS will accept a Form I-693 Vaccination Report completed by a health department on behalf of the refugee seeking adjustment of status, provided it was completed in accordance with the form’s instructions and the following:

• Health departments participating in the HQOPRD blanket civil surgeon designation will place either the official stamp or raised seal (whichever is customarily used by that specific health department) on the vaccination supplement;
• The attending health department physician must sign it. In accordance with the agreements reached with CDC, the signature on the vaccination supplement may be the physician’s actual (original) or stamped signature. The health department nurse or other health care professional may, but is not required to cosign the vaccination supplement; and
• The health department must place the signed vaccination supplement in a sealed envelope, according to the standard procedures all civil surgeons are required to follow.

Blanket Designation of Certain Physicians Employed by the Armed Forces

To ease difficulties encountered by physicians and applicants in the military, USCIS issues a blanket civil surgeon designation to qualifying military physicians to permit them to perform the immigration medical examination and complete Form I-693, Report of Medical Examination and Vaccination Record, for eligible members and veterans of the armed forces and their dependents.

Participation in this blanket civil surgeon designation is entirely voluntary and at the discretion of each military medical facility. This blanket designation only applies to military physicians who:

• Meet the professional qualifications of a civil surgeon, as described in the Professional Qualifications Required to Be a Civil Surgeon section of this Web page. However, the physician may be licensed in any state, and is not required to be licensed in the state in where the physician is performing the immigration medical examination;
• Are employed by the Department of Defense (either as armed forces physicians or as civilian physicians) or are civilian contract providers; and
• Are authorized to provide medical services at a Medical Treatment Facility (MTF) located within the United States for armed forces personnel, veterans, and dependents.

Medical facilities or physicians who qualify for and wish to participate in the blanket designation do not need to obtain approval from USCIS before performing immigration medical examinations for armed forces personnel, veterans, and dependents at a MTF.

A military physician operating under the blanket civil surgeon designation is required to certify the Form I-693 by providing the following on the form:

• The blanket designated civil surgeon’s signature on Form I-693. The signature may be the original (handwritten) or stamped signature. Nurses or other health care professionals may, but are not required to, cosign the Form I-693;
• The official stamp or raised seal of the MTF; and
• The signed Form I-693 must be placed in a sealed envelope, according to the instructions listed on the form.

USCIS Civil Surgeon Locator

A public list of designated civil surgeons is available online through the Civil Surgeon Locator.

Because blanket designated health departments or blanket designated military physicians do not have to apply for civil surgeon designation, they are not listed in the Civil Surgeon Locator.