Before an N-648 evaluation, gather diagnosis documentation, brain imaging and lab reports, and current medication lists. Also gather functional evidence (how the person copes day to day), such as caregiver notes or past cognitive testing. Records from other countries count too.
The strongest N-648 begins at your kitchen table, with a folder. A disability waiver stands or falls on medical evidence. Gather it before you book anything.
The Core Checklist
Diagnosis documentation: clinic notes, hospital discharge summaries, and neurology or psychiatry consultations. They should name the condition and the dates. Imaging and labs: brain imaging reports (CT/MRI) for stroke or dementia, and related lab results. Medication history: current medication lists that show treatment for the qualifying condition. Functional evidence: home health assessments, caregiver documentation, and past cognitive testing if any exists.
Records From Other Countries Count
Many families assume foreign records are useless. Wrong. Take a hospital record from Bosnia, Vietnam, or Mexico that documents a stroke or the early course of dementia. It establishes the timeline: how long the condition has existed. That speaks directly to the 12-month duration requirement. Have them translated. Even partial records help.
How do you request medical records for an N-648?
Call each clinic’s medical records office. Ask for records under HIPAA (the federal health privacy law). Providers must give them to the patient or an authorized representative. Ask for visit notes, imaging reports (not just discs), and problem lists. Allow two to three weeks. Bring everything to the evaluation. A physician who reviews a documented history writes a categorically stronger certification than one working from a single visit.
Related reading: Dementia, Citizenship and the N-648: A Family Guide · N-648 Disability Waiver for the Citizenship Test · Form N-648 Disability Waiver Evaluation
Frequently Asked Questions
What records matter most for an N-648?
Documentation that establishes the diagnosis, how long it has lasted, and how it affects daily life. That means specialist notes, imaging reports, hospital summaries, medication lists, and any past cognitive testing.
Do medical records from outside the U.S. help?
Yes. Foreign records establish how long the condition has existed. That supports the 12-month duration requirement. Translation is recommended.
How do I request records from a clinic?
Call the medical records office. Ask for them under HIPAA as the patient or authorized representative. Ask for visit notes, imaging reports, and problem lists by name.
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Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — USCIS-designated civil surgeon (CSID 111051), board certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed September 2026.