Form N-648 · Citizenship Test Waiver · Direct Booking
N-648 evaluation · St. Louis
Schedule Your N-648 Evaluation
Pick your time below. A $100 non-refundable scheduling fee reserves your appointment and is credited toward your N-648 fees. Bring your existing medical records.
Booking opens in a secure Calendly window. If the calendar doesn’t load, open it directly.
Already booked? Complete the N-648 patient information form →
Who qualifies for an N-648 evaluation?
Form N-648 lets a licensed physician certify that a medical condition prevents a citizenship applicant from learning English or U.S. civics. Then the applicant may be excused from those tests.
Book only if all of these are true:
- Severe memory loss or severe cognitive impairment (trouble with thinking and memory). It comes from a condition such as dementia, stroke, developmental disability, or severe psychiatric illness. It has lasted, or is expected to last, 12 months or more.
- Your existing medical records. Neurology, psychiatry, primary care, imaging, and prior testing. Cases without records to back them up generally cannot be accepted.
- An interpreter for your language if you do not speak English. The applicant pays interpreter fees directly.
We accept only cases with genuine medical merit. If your case does not qualify, we tell you honestly and decline it.
Psychometric testing
Your cognitive function is measured with standardized, validated instruments appropriate for patients with limited formal education: the Montreal Cognitive Assessment (MoCA), the VA Saint Louis University Mental Status (SLUMS) examination and, in some cases, Cognivue computerized cognitive testing. Testing is administered in your own language through an interpreter. Dr. Padda is a MoCA Certified Rater and USCIS-designated civil surgeon (CSID 111051). The scored results are documented in your Form N-648 and in your medical summary.
What you receive
- Your completed, physician-signed Form N-648, Medical Certification for Disability Exceptions (current USCIS edition), as a PDF.
- A medical summary in plain words, on office letterhead.
See the official blank form: USCIS Form N-648 (PDF).
How much does an N-648 evaluation cost?
- $100 scheduling fee at booking, non-refundable, credited toward your N-648 fees.
- Records review and case acceptance: $400, non-refundable. If your case is accepted, the full $400 is credited toward your evaluation.
- Evaluation and certification: from $1,400. The fee varies with how much analysis and document review your case requires.
- USCIS-requested revisions: $190, for patients we evaluated within the past 12 months. Cases beyond 12 months, or first evaluated elsewhere, require a full re-evaluation.
Prefer to talk first?
Text or call us and our staff will answer your N-648 questions, in your language if needed.
Where you’re going
Directly next to St. Louis Lambert International Airport.
ImmigrationExam.us
4477 Woodson Rd, Suite 102
St. Louis, MO 63134
Directions
Frequently asked questions
How is memory and thinking tested for an N-648?
We measure your thinking and memory (cognitive function) with standardized, validated tests. They suit patients with limited formal schooling: the Montreal Cognitive Assessment (MoCA), the VA SLUMS examination and, in some cases, Cognivue computerized testing. Testing is given in your own language through an interpreter. You pay the interpreter’s fees directly. Dr. Gurpreet Singh Padda, MD, MBA, MHP is a MoCA Certified Rater. The scored results go into your Form N-648 and your medical summary.
What should I bring to my N-648 appointment?
Bring your existing medical records: neurology, psychiatry, primary care, imaging and prior testing. Cases without records to back them up generally cannot be accepted. If you do not speak English, arrange an interpreter for your language. After you book, fill out the N-648 patient information form. That way the office has your details before the visit.
What do I receive after the N-648 evaluation?
You receive your completed, physician-signed Form N-648, Medical Certification for Disability Exceptions. It comes in the current USCIS edition as a PDF. You also get a plain-language medical summary on office letterhead. If USCIS requests revisions within 12 months of your evaluation, they are $190. Cases beyond 12 months, or first evaluated elsewhere, need a full re-evaluation.
Does an N-648 guarantee I will be excused from the citizenship test?
No. Only USCIS decides whether an N-648 is sufficient, and no physician can guarantee approval. We accept only cases with genuine medical merit and do not certify cases that lack medical justification. The 100% Money-Back Guarantee covers I-693 exams only, not N-648 evaluations, so read the requirements above before you book.