I-910, Application for Civil Surgeon Designation

Purpose of Form

Depending on the immigration benefit sought, an applicant may be required to undergo a 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.)

Generally, physicians interested in obtaining civil surgeon designation must apply using Form I-910. Certain physicians may not need to apply for civil surgeon designation if they fall under a limited number of blanket designations. Please refer to the instructions to determine whether you should use this form. For more information, see the USCIS Policy Manual Blanket Civil Surgeon Designation Guidance.

The National Benefits Center is accepting applications for civil surgeon designation. USCIS has the authority to exercise discretion in approving civil surgeon applications based on local requirements. See 8 CFR 232.2.  At this time, USCIS does not foresee invoking any local restrictions, but reserves the right to apply such restrictions.

Number of Pages

Form 7; Instructions 10.

Edition Date

12/23/16. No previous editions accepted. You can find the edition date at the bottom of the page on the Form and Instructions.

Where to File

USCIS
PO Box 660812
Dallas, TX 75266

 

Filing Tips for Form I-910, Application for Civil Surgeon Designation
 
Complete all sections of the form. The form will be rejected if these fields are missing:

  • Part 1 – Information About You
    • Family Name
    • Given Name
    • Date of Birth
  • Part 2 – Clinical Office Locations
    • Physical Address of the Clinic/Practice
  • Part 8 – Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant
    • Preparer’s Signature (if applicable)

 

Sign the form in Part 7, Item Number 5.a., Applicant’s Signature. The fillable version of Form I-910 now includes a “Don’t forget to sign!” message and an arrow pointing to the signature box as a reminder for when you print the completed form for mailing. If there is no signature in Part 7, USCIS will reject the form and return it for correction and re-filing.
 

Filing Fee

$785, effective 12 a.m. Eastern U.S. time, December 23, 2016. There is no fee for an application from a medical officer in the U.S. Armed Forces or civilian physician employed by the U.S. Government who examines members and veterans of the Armed Forces and their dependents at a military, Department of Veterans Affairs, or U.S. Government facility in the United States.

Special Instructions

Special Instructions

If you are filing at a USCIS Lockbox facility, please read these important Lockbox filing tips.

To ensure the Lockbox accepts your Form I-910:

  • Submit the correct fee
  • Fill out the form completely and accurately, particularly these required fields:
    • Family Name
    • Given Name
    • Date of Birth
    • Physical Address of the Clinic/Practice
    • Applicant’s Signature
    • Preparer’s Signature (if applicable)

For detailed information about the medical examinations:

To notify USCIS of any changes about your civil surgeon designation (including any changes to contact information listed on the Civil Surgeon Locator), email your updates to public.engagement@uscis.dhs.gov.

This page can be found at https://www.uscis.gov/i-910

Last Reviewed/Updated:

ADDITIONAL INFORMATION