Medical Exemptions · Citizenship Test Waiver
Form N-648 Disability Waiver Evaluation
Some applicants for U.S. citizenship cannot learn English or U.S. civics because of a medical condition — such as dementia, stroke, developmental disability, or severe psychiatric illness — lasting 12 months or more. Form N-648 lets a licensed physician certify that condition so the applicant may be excused from the English and civics tests.
Evaluations performed by Dr. Gurpreet Padda, USCIS-designated civil surgeon (CSID 111051) and MoCA-certified rater · Service launch announced on major newswires, July 2026
How our N-648 evaluation works
Records review & case acceptance — $400
Non-refundable. Before scheduling, we screen your case and review your medical records (neurology, psychiatry, primary care, imaging, testing). We only accept cases with genuine medical merit — if your case does not qualify, we tell you honestly and decline it. If accepted, the full $400 is credited toward your evaluation fee.
Evaluation & certification — from $1,400
The in-person visit at our St. Louis office: a standardized cognitive assessment administered in your own language through an interpreter, completion of Form N-648, and a plain-language medical summary on office letterhead. The fee varies with the extent of analysis and document review your case requires; the $400 is credited, so accepted patients pay the balance.
Dr. Padda is a MoCA Certified Rater and USCIS-designated civil surgeon (CSID 111051) — cognitive testing uses validated instruments appropriate for patients with limited formal education, administered in your own language.USCIS-requested revisions — $190
For patients we evaluated within the past 12 months. Cases beyond 12 months, or originally evaluated elsewhere, require a full re-evaluation. Interpreter fees are paid directly by the applicant.
Dr. Padda explains the N-648, on camera
Hear the owning physician break down the federal criteria and the mistakes that sink most waivers.
Think your case qualifies?
Text us to begin the records review. We’ll tell you honestly whether your case has medical merit.