Mental Health

Cultural Competency/Cultural Humility

Additional Resources

Adjustment of Status - Civil Surgeon Services

Immigrants and refugees who have been in the U.S. for one year may complete medical evaluations to adjust their status and obtain a Green Card. Requirements differ for refugees and immigrants, so it is important to first determine whether the individual is designated as a refugee or an immigrant. In most cases, they will know their designation, and refugees will have the word "refugee" printed on their I-94 card.

The U.S. Citizenship and Immigration Services Form I-693 is used to report results of a medical examination and record immunizations. It must be signed by the civil surgeon or by a physician affiliated with the local public health agency completing the review. To find an authorized doctor for green card (adjustment of status), visit Find a Doctor. For Technical Instructions for Civil Surgeons, visit CDC Technical Instructions for Civil Surgeons. Please note the Adjustment of Status screening results are not entered into IRHAS. The USCIS Multilingual Resource Page has its materials in languages other than English. 

Refugee requirements:

  • Refugees must meet vaccination requirements according to age-appropriate recommendations by the Advisory Committee for Immunization Practices (ACIP). Because completion of a vaccine series often requires several months, applicants are required to complete at least one dose of each vaccine by the time of assessment for the I-693, and are encouraged to follow up with a primary health care provider to complete the series. However, the applicant must complete the entire vaccine series for COVID-19 (one or two doses depending on the formulation).
  • Refugees who arrived to the U.S. with a Class A condition require the entire medical exam, including any necessary vaccinations.
  • Refugees who arrived to the U.S. without a Class A condition require only review and update for immunizations. These refugees should submit the entire Form I-693 and complete the following sections:
  • Part 1:  Information about you
  • Part 2:  Interpreter contact information, certification, and signature
  • Part 4:  Civil surgeon’s contact information, certification, and signature
  • Part 7:  Vaccination record