Appointments become available approximately one week in advance. New Patient Appointment,must email first.
Returning Patient

Immigration Physical Exams

Also called USCIS Medical Exam, Green Card Medical Exam, Form I-693, INS Physical
Dr. Tara Zandvliet is a designated Civil Surgeon for the U.S. Citizenship and Immigration Services (USCIS) through the Department of Homeland Security. Her office is in San Diego.
The cost of an Immigration Physical includes:
  • Basic Physical Examination
  • Confirmation of blood and urine tests (syphilis - RPR, Quantiferon for tuberculosis, urine for gonorrhea)
  • Confirmation of vaccine history
  • Copies of your laboratory results
  • Certified and sealed I-693 form
  • One to two office visits.

    The initial office visit includes your physical examination, administration of any vaccines needed, and ordering of blood tests.  If your TB test is positive, you will then need an x-ray, and another visit 2 days after you have your x-ray for final paperwork.

To schedule:

Please email In the email request an appointment for an INS Physical.
What to bring with you to the appointment:
  • Valid, government issued picture ID such as a driver's license or passport (preferred).
  • Proof of prior vaccinations. If you have had them done in the United States, you can call the office where it was done and get copies. Without proof, you will need the vaccines listed in the next section.
  • Immigration Physical Form I-693, pre-completed with your information if possible. DO NOT sign your I-693; your signature must be completed in front of Dr. Zandvliet. You can download a form and directions at:
Vaccines and Tests (Additional Cost):
  1. The syphilis, tuberculosis, and gonorrhea tests run $40 to $200 each depending on the lab.
  2. If your tuberculosis test is positive, you will need an x-ray, which is done at Imaging Healthcare for about $70.
  3. You will also need vaccinations or blood titers to prove immunity (generally $50 to $75 each).
Requirements by age:
Children under 18 18-65 years old Over 65 years old
Tuberculosis test Tuberculosis test Tuberculosis test
All school required vaccines MMR (2 in lifetime) MMR (2 in lifetime, or none if born before 1957)
  Flu shot in fall/winter Flu shot in fall/winter
  Tetanus booster (in last 10 years) Tetanus booster (in last 10 years)
  Syphilis blood test Syphilis blood test
    Pneumonia vaccine (in last 5 years)
    Shingles vaccine (only once)
  Gonorrhea test Gonorrhea test
After the last part of the immigration physical examination is completed, Dr. Zandvliet will certify Form I-693 with the test results of the immigration exam and vaccination history in a sealed envelope to present to the INS. DO NOT OPEN THE SEALED ENVELOPE. Turn in the envelope with your immigration application. A copy of your blood tests results will be provided for you to keep after results have been discussed. The examination will only be valid up to a year after the immigration exam date.
Congratulations on taking this important step towards the American Dream!