Updated November 7, 2026

US immigrant visa medical exam: panel physicians, vaccines and what to bring

If you are applying for a US immigrant visa or a K visa from abroad, you must complete your medical exam with a panel physician appointed by the local US embassy or consulate. According to the Centers for Disease Control and Prevention (CDC), more than 760 panel physicians worldwide conduct these overseas exams, which include a physical and mental evaluation, tuberculosis and syphilis testing, and a vaccination review.

The doctor sends your results to the embassy, and travel clearance is valid for 6 months for most applicants with normal results or 3 months if you require sputum cultures.

What is a panel physician and how do you find one?

A panel physician is a medically trained, licensed doctor practicing overseas who is appointed by the local US embassy or consulate to perform predeparture immigration medical exams. You cannot use your personal family doctor for this step, and this overseas exam is separate from the exam conducted inside the United States by a USCIS-designated civil surgeon on Form I-693.

More than 760 panel physicians perform these exams worldwide under technical instructions set by the CDC Division of Global Migration Health, Quality Assessment Program (QAP). These instructions apply to people seeking immigrant or refugee status, as well as certain nonimmigrants required to have an overseas medical exam, such as K-1 visa applicants. See our guide to K-1 visa requirements if you are applying as a fiance(e).

To find an approved doctor and check the exam fee for your location, contact the consular or visa section of your specific US embassy or consulate, or check the Department of State website for your embassy's current list.

During your visit, the panel physician verifies your identity using Department of State procedures, completes the physical exam, orders the required chest radiograph and laboratory work, and sends the completed medical report forms directly to the consular officer. The panel physician does not decide whether you qualify for a visa. That final decision belongs to the consular officer after reviewing your full record and your medical report.

What to bring to your panel physician appointment

Bringing the right clinical records to your appointment prevents repeat tests and extra vaccines. Use this checklist prepared by our team to pack your medical folder before your visit, and check our full list of documents required for a US visa interview for what to take to the embassy afterward.

• Identification required by the US Department of State so the clinic can verify that the person appearing for the exam is the person applying for the visa.
• All available written vaccination records, such as a personal vaccination record or a copy of a medical chart with entries made by a doctor or appropriate medical staff. Every vaccine entry must show the exact month, day, and year of receipt, must not appear altered, and must have reasonable dates. Self-reported doses without written proof are not accepted.
• Prior chest X-rays, if you have them, so the radiologist and panel physician can compare them with your new digital radiograph.
• Written documentation from a physician of any previous positive interferon-gamma release assay (IGRA) blood test for tuberculosis. To be accepted in place of a new IGRA, the record must state the date of the test, the type of IGRA performed, the test results in standard units of measurement, the positive interpretation, and the testing physician's name, signature, and office information.
• Detailed treatment records if you were ever treated for infectious tuberculosis disease and refused directly observed therapy (DOT). A simple doctor's note saying you were treated is not enough. Bring records showing each medication name, dosage, and delivery date, plus the treating doctor's name and clinic city and state. Include all sputum smear, molecular test, culture, and drug susceptibility testing (DST) results, along with chest X-ray reports from the treatment center.
• documentation of any prior syphilis treatment history and previous laboratory results, including nontreponemal test titers if available, so the panel physician can include them in your packet or eMedical file.

What the US immigrant visa medical exam includes

Every applicant undergoes a physical and mental examination to check for conditions that could affect admissibility under the Immigration and Nationality Act. The CDC Technical Instructions for panel physicians cover eight core areas: medical history and physical examination, tuberculosis, vaccinations (including an addendum for polio vaccination), mental health, gonorrhea, syphilis, Hansen's disease (leprosy), and other physical or mental abnormalities, diseases, or disabilities.

During the physical examination, the doctor checks your height, weight, temperature, heart rate, respiratory rate, and blood pressure. They also perform a pulmonary exam, inspect and palpate your lymph nodes, and check for scars from scrofula or prior chest surgery.

Routine HIV testing is not required. On November 2, 2009, the Department of Health and Human Services published a final rule removing HIV infection from the list of inadmissible conditions, and the rule took effect on January 4, 2010. Panel physicians may still advise voluntary HIV testing if it is clinically indicated, such as when an applicant has signs or symptoms suggestive of HIV or has tuberculosis disease. If you consent to voluntary testing, you must understand that the test is optional, you do not have to be tested by a panel physician, and any test performed by the panel physician must be included on your completed immigration paperwork.

Age-based screening requirements for US immigration medical exams

Tuberculosis and syphilis screening rules

Under the CDC tuberculosis screening rules (effective January 24, 2024, with updated molecular, adult IGRA, and drug susceptibility rules in effect by October 1, 2024), your tuberculosis (TB) screening depends on your age and whether the country of your exam has a World Health Organization (WHO)-estimated TB incidence rate below 20 cases per 100,000 population or 20 and above.

In low-burden countries (fewer than 20 cases per 100,000), applicants under age 15 receive a medical history and physical exam, and only need an IGRA (or tuberculin skin test under age 2), chest X-ray, and sputum testing if they have TB signs or symptoms or known HIV infection. Applicants age 15 and older must have a medical history, physical exam, and a chest X-ray. In high-burden countries (20 or more cases per 100,000), children under age 2 receive a medical history and physical exam unless symptoms or known HIV trigger further testing. All applicants age 2 and older must have an FDA-approved or WHO-approved IGRA blood test. Children ages 2 through 14 then need a chest X-ray only if their IGRA is positive, they have TB signs or symptoms, or they have known HIV. Applicants age 15 and older in high-burden countries must have both an IGRA and a chest X-ray regardless of the IGRA result.

When sputum testing is required, applicants must provide three early morning fasting specimens of 5 to 10 mL collected at least 24 hours apart under direct observation after rinsing with purified or distilled water, without brushing teeth, using mouthwash, or eating beforehand. Specimens undergo molecular testing (NAAT) on the first sample, AFB smears, and two solid (LJ) plus one liquid (MGIT) culture per sample (9 cultures total).

If you provide written proof of a past positive tuberculin skin test (TST), you must still take the IGRA blood test, and if that IGRA is negative, you are considered to have a negative immune response. An indeterminate IGRA is recorded as indeterminate and does not trigger repeat testing, a chest X-ray, or a Class B2 classification. Latent Tuberculosis Infection (LTBI), which typically presents as a positive IGRA with a negative chest X-ray and no symptoms in a person without HIV, is not infectious, so treatment is not required to immigrate. Pregnant applicants may postpone the required immigration chest X-ray and medical exam until after pregnancy, though a chest X-ray is required to immigrate and you should ask a consular officer if delaying affects your case. Lead shielding is no longer recommended or required for any applicant, including pregnant women.

Under the CDC syphilis rules (effective September 3, 2021, updated January 30, 2025), all applicants aged 18 to less than 45 years must be tested for syphilis, along with anyone outside that range if infection is suspected. The panel physician orders your blood test at the time of your exam, and the designated clinic lab runs it using the traditional testing algorithm: first a nontreponemal screening test (VDRL or RPR) with a quantitative titer reported (such as 1:4) if reactive, confirmed on the same blood sample using an approved treponemal test (TP-PA, TPHA, EIA, CIA, FTA-ABS, or an FDA-approved or WHO-recommended immunoblot or rapid assay). An external genital, anal, or rectal exam is not required during a routine check and must only be performed after laboratory confirmation of a syphilis diagnosis, with a gown or sheet for privacy and a staff chaperone present. If both blood tests are reactive, you are classified as Class A for syphilis until treated (typically with benzathine penicillin G), after which your classification changes to Class B and you are cleared for travel.

Vaccination requirements, Form DS-3025 and K visa rules

Under the CDC vaccination instructions (updated March 11, 2025), immigrant visa applicants must show proof of age-appropriate vaccination or immunity against 15 diseases: Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, Rotavirus, Haemophilus influenzae type b (Hib), Hepatitis A, Hepatitis B, Meningococcal disease, Varicella, Pneumococcal disease, and Influenza. By our calculation from CDC Table 1, an adult applicant aged 18 to 59 is evaluated for up to 6 age-appropriate vaccine rows (Tdap/Td, Polio IPV, Measles/Mumps/Rubella, Hepatitis B, Varicella, and seasonal Influenza), whereas a 1-year-old child is evaluated across 9 vaccine rows.

Because vaccine series take months or years to finish, you only need to receive from the panel physician at least one dose of each age-appropriate vaccine for which you are not currently up to date. The panel physician records your valid written vaccination history and any shots given at the exam on the US Department of State Vaccination Documentation Worksheet (Form DS-3025) and must give you an extra personal copy to keep for healthcare providers, schools, and adjustment of status after you arrive in the United States.

If you lack written vaccine records, laboratory blood titer evidence of immunity is accepted for seven diseases: measles, mumps, rubella, hepatitis A, hepatitis B, polio (titers must cover all three poliovirus types), and varicella. For varicella (chickenpox) only, a reliable written or oral history of disease is accepted if you describe an epidemiologic link to another typical or lab-confirmed case, or show lab confirmation from the time of illness.

K-1 and K-2 visa applicants are not required to receive vaccines before traveling to the United States, though they must meet vaccination requirements later when applying for adjustment of status. If you are a K visa applicant and bring reliable vaccination records, the panel physician will still complete Form DS-3025 and give you a copy. For internationally adopted children age 10 or younger, overseas vaccination requirements do not apply if the adoptive parent signs an affidavit before admission promising the child will receive all required shots within 30 days of US arrival.

You do not apply for a medical Blanket Waiver. The panel physician checks one of the six 'Not Medically Appropriate' reasons on Form DS-3025: not age-appropriate, insufficient time interval between doses, contraindicated, not routinely available in the country, flu vaccine not available, or known chronic hepatitis B virus infection. If you object to vaccines based on religious or moral convictions, you must submit an individual waiver request to USCIS. Refusing a medically appropriate required vaccine without applying for a waiver makes an immigrant visa applicant inadmissible (Class A).

CDC Table 1: Vaccine requirements by applicant age for panel physicians

Timeline, eMedical USA, DS forms and how long results are valid

If your medical results have not reached the embassy by your interview, the officer may place your case on hold under a 221(g) refusal until the report arrives. See our guides on 221(g) administrative processing and CR-1 visa processing time for how delays affect your schedule. Use these mandatory CDC laboratory and clinical timelines to plan your appointment:

• Chest X-ray turnaround: Results should be available the same day and no later than 3 days from when performed.
• IGRA blood test turnaround: Results must be available within 72 hours of sample collection.
• Recent respiratory illness wait: If you are treated with antibiotics for a common bacterial respiratory tract infection, your screening chest X-ray should not be performed until at least 8 weeks after treatment (unless clinical status requires earlier evaluation).
• Sputum culture incubation: Liquid cultures (MGIT) must be incubated for a minimum of 6 weeks and solid cultures (LJ) for a minimum of 8 weeks before a final negative report is issued.
• Drug susceptibility testing (DST): For positive M. tuberculosis cultures, panel physicians must have access to DST results within 10 weeks of sputum collection.
• Refusing DOT treatment wait: If you refuse DGMH-defined DOT for active infectious TB, you must wait at least 1 year after finishing treatment before repeating the medical exam.

Medical exam travel clearance validity by CDC classification

How panel physicians send your results and what they ask

Panel physicians record your exam findings in English either electronically inside the eMedical USA system (including the 712 Syphilis Test exam module) or on four paper US Department of State forms: Report of Medical Examination by Panel Physician (DS-2054), Vaccination Documentation Worksheet (DS-3025), Medical History and Physical Examination Worksheet (DS-3026), and Tuberculosis Worksheet (DS-3030). When paper forms are used, they are included in your travel packet, and for all Class A and Class B1 conditions, all required paper medical documentation and original laboratory reports must be sent by courier or other secure means directly to the US embassy. Incomplete documentation can lead to a visa refusal or a medical hold at the US port of entry. Your syphilis travel clearance is valid for the exact same length of time as your TB evaluation.

[PRACTICE_BOX]

Both the panel physician and the consular officer ask targeted health and timing questions to complete your forms and check your eligibility. Here is what they ask, what each question checks, and what records to have ready:

1. "Have you ever had a cough lasting 3 weeks or more, fever, night sweats, weight loss, or coughing up blood, or lived in the same household with someone who had tuberculosis?" What it checks: The doctor must screen for symptoms of infectious TB and determine whether you are a recent contact (Class B3) who shared enclosed air space for days or weeks with a smear- or culture-positive TB patient. How to prepare: If you were ever treated for latent or active TB, bring the exact treatment dates, medication names, dosages, and past chest X-rays.

2. "Do you have written records showing the exact month, day, and year of your vaccinations, or did you ever have chickenpox?" What it checks: Panel physicians only transcribe vaccine doses onto Form DS-3025 from an unaltered written record showing the month, day, and year, though they accept a reliable oral or written history of varicella (chickenpox) if it links to a typical or lab-confirmed case. How to prepare: Bring your immunization records and be ready to state when you had chickenpox and whether a family member or classmate had a typical case at the same time.

3. "Have you ever been diagnosed with or treated for syphilis, or had painless sores on the genitals, anus, or mouth, or a rash on your palms or the soles of your feet?" What it checks: Panel physicians must ask every applicant these exact history questions and compare past nontreponemal titers against your new exam lab test. How to prepare: Bring documentation of any prior syphilis drug regimen, start and completion dates, and previous lab titers so the doctor can record them on Form DS-3026 or in eMedical.

4. "Has your medical exam been completed, and when do your medical results expire?" What it checks: At the embassy window, the consular officer checks that your eMedical file or DS-2054 packet has arrived and that you can enter the United States before your 6-month or 3-month travel clearance expires. How to prepare: Bring your DS-3025 copy to your visa interview and know the completion date of your medical evaluation.

Visaful is an AI mock interview app for US visa interviews: an AI officer asks your visa's questions out loud and shows what to fix.

This is interview practice, not legal advice. For questions about your own case, talk to an immigration attorney. Visaful is not affiliated with U.S. Citizenship and Immigration Services (USCIS), the U.S. Department of State, U.S. Customs and Border Protection (CBP) or any government agency.