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Tag: immigration medical exam

  • The #1 Cause of I-693 Delays: Vaccination Gaps (Fix Them Before You Book)

    The #1 Cause of I-693 Delays: Vaccination Gaps (Fix Them Before You Book)

    The #1 Cause of I-693 Delays (Fix It Before You Book) — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    Vaccination gaps are the most common cause of delay in the immigration medical exam. They are also the most preventable. The fix happens before you ever book.

    Why aren’t my routine adult vaccines enough for immigration?

    Most people assume they’re “up to date” because of a physical last year or their childhood shots. But the CDC immunization requirements for immigration are their own standard. They are specific and absolute. They get updated from time to time. Requirements people commonly miss include these. Tdap (not just an old tetanus shot). Varicella. Polio, which since May 1, 2024 applies to adults who cannot document a complete childhood series. And hepatitis B, required through age 59 since April 2022.

    Do I have to repeat vaccines if I have records?

    Here’s the part that saves money and needles. A documented dose counts; a remembered dose doesn’t. Records in any language are acceptable. Before booking, gather every vaccine record you can find. That means childhood cards, school records, employer health files, pharmacy printouts, and records from your home country. What you can document, you don’t repeat.

    How do I check my vaccine records before I book?

    Line your records up against the current CDC Technical Instructions for civil surgeons (the vaccine section is public). Note the real gaps. Then book. Either fill the gaps first with your own provider, or plan to finish them at the exam. People who do this check routinely turn a multi-visit process into a single appointment.

    Related reading: I-693 Foreign Vaccination Records · Organize Medical Records for Your I-693

    Frequently Asked Questions

    Which vaccines do immigration applicants most often miss?

    Tdap and varicella are the ones most commonly missed. Two adult rules trip people up. The first is polio. Since May 1, 2024 it applies at any age. The exception is when a complete series is documented. The other is hepatitis B, required through age 59. See the age-by-age vaccine requirements.

    Are vaccine records from another country acceptable?

    Yes. Written records in any language are accepted as evidence of vaccination. Documented doses do not need to be repeated.

    Can I get missing vaccines at the exam?

    Missing vaccines can typically be given or set up during the process. But coming with complete records is always faster and cheaper.

    Do I need the hepatitis B vaccine for a green card?

    Yes, if you are in the age range. Hepatitis B has been required through age 59 since April 2022. It is one that people most often miss. If you already had the series, bring the written record. A documented dose counts and does not need to be repeated. A dose you only remember does not count.

    Do adults need the polio vaccine for the immigration exam?

    Since May 1, 2024, the polio requirement applies to adults who cannot document a complete childhood series. Do you have a record showing the full series? It could be your childhood vaccine card, a school record, or a record from your home country. Bring it. Records in any language are acceptable. What you can document, you do not repeat.

    What counts as proof of vaccination for the I-693?

    Written records count. Gather childhood vaccine cards, school records, employer health files, pharmacy printouts and records from your home country. Records in any language are acceptable. A documented dose counts toward the requirement. A remembered dose does not. Bring every record you can find to the exam. That way, doses on paper are not given again.

    Can missing vaccines delay my green card medical exam?

    Yes. Vaccination gaps are the most common cause of delay in the immigration medical exam. They are also the most preventable. Before you book, line your records up against the CDC Technical Instructions. Note the real gaps. Then fill them with your own provider, or plan to finish them at the exam. That check routinely turns a multi-visit process into one appointment.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • Why Your Civil Surgeon Seems ‘Cold’ — and Why That Protects You

    Why Your Civil Surgeon Seems ‘Cold’ — and Why That Protects You

    Why Your Civil Surgeon Seems "Cold" ⚖️ (And Why That Protects You) — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    Your civil surgeon seems cold for a reason. A civil surgeon is designated by USCIS to verify medical facts for the government. The job is not to act as your personal doctor. That neutrality is what makes adjudicators (the USCIS officers who decide your case) trust the form the civil surgeon signs. So a detached exam protects your filing.

    You’re the patient. But the U.S. government is the client. That’s the paradox at the center of every immigration medical exam. It is the hardest thing for applicants to accept.

    Who does a civil surgeon work for?

    Your own doctor works for you: your comfort, your outcomes, your story. A civil surgeon is designated by USCIS to verify facts for the government. When you walk into a civil surgeon’s office, the professional loyalty in the room shifts. It does not shift against you. It shifts toward the accuracy of a federal document. If the visit feels detached, that isn’t indifference to you as a person. It’s indifference to everything that doesn’t affect your filing.

    Why does the civil surgeon seem so detached?

    An objective examiner produces a document adjudicators trust. A civil surgeon known for precision and neutrality lends that trust to every form they sign. That includes yours. The opposite is also true. Some examiners are seen as advocates or rubber stamps. They invite a closer look at every applicant who walks through their doors.

    How should I answer the civil surgeon’s questions?

    Answer questions directly. Don’t over-explain. Don’t add opinions. Don’t try to “sell” your history. The law doesn’t want your story; it wants your data. Over-explaining creates noise, and noise creates follow-up questions. The best exam is one where every answer is accurate and complete. Each answer is exactly as long as it needs to be.

    Related reading: USCIS Medical Exam Is Not a Physical: What It Is · Organize Medical Records for Your I-693 · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis

    Frequently Asked Questions

    Is the civil surgeon working for me or for USCIS?

    The civil surgeon is designated by USCIS. The job is to verify medical facts for the government. Your own physician is still your advocate for health care choices.

    Should I explain the background behind my medical history?

    Answer questions accurately and directly. Long stories add noise. They do not help. The form requires data, not context.

    Does a detached exam mean something is wrong with my case?

    No. Professional neutrality is what makes adjudicators trust the certification. It protects your filing.

    What is a civil surgeon?

    A civil surgeon is a physician designated by USCIS. The civil surgeon performs the immigration medical exam. They verify medical facts for the government on Form I-693. Dr. Gurpreet Singh Padda, MD, MBA, MHP, is the USCIS-designated civil surgeon (CSID 111051) at 4477 Woodson Rd in St. Louis. His job at the exam is to produce an accurate federal document. It is not to manage your ongoing health care.

    Is a civil surgeon the same as a regular doctor?

    No. Your own doctor works for you: your comfort, your outcomes, your story. A civil surgeon is designated by USCIS to verify facts for the government. So the professional loyalty in the room shifts toward the accuracy of a federal document. That is why the visit can feel detached. It is not indifference to you as a person.

    How much is a civil surgeon visit?

    At our St. Louis office the I-693 immigration medical exam is a flat $390. A follow-up visit is $190. The fees are listed in the contact box on this page. To book your exam with Dr. Padda, you can schedule online, call (314) 960-9100, or text (314) 886-5902.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • Your USCIS Medical Exam Is Not a Physical — Here’s What It Actually Is

    Your USCIS Medical Exam Is Not a Physical — Here’s What It Actually Is

    Your USCIS Medical Exam Is Not a Physical 🛂 Here's What It Actually Is — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    The USCIS medical exam (Form I-693) is not a physical. It screens only for a short list of conditions. Federal immigration law sets that list. It covers certain communicable diseases (diseases that spread), vaccination compliance, mental health conditions associated with harmful behavior, and substance abuse. Your general health is not being judged. That includes high blood pressure, diabetes or arthritis.

    You’re anxious because you think the government is judging your health. It isn’t. Once you see what the I-693 exam really is, and is not, the fear falls apart.

    A Compliance Filing, Not a Health Verdict

    The single biggest cause of needless fear in the immigration medical exam is a mix-up. People confuse a primary care visit with a USCIS compliance filing. They are not the same. Your personal doctor is on your side. A civil surgeon is a checker. The I-693 screens for a short, specific list of conditions. Federal law defines that list. It covers certain communicable diseases, vaccination compliance, mental health conditions associated with harmful behavior, and substance abuse. Nothing else is being checked.

    What does “inadmissible health condition” really mean?

    Under the USCIS Policy Manual (Volume 8, Part B), health-related inadmissibility is narrow. Most of it can be resolved. High blood pressure isn’t on the list. Diabetes isn’t on the list. Arthritis, high cholesterol, old injuries: none of it. Applicants routinely fear conditions the law does not care about. Meanwhile they miss the documentation the law really requires.

    Lower the Expectations, Raise the Certainty

    Don’t come expecting a caring talk about your overall health. That’s what your own physician is for. Mixing the two creates friction and delay. Come expecting a precise, respectful, well-run compliance process. Your ID is checked. Your history is reviewed. Required tests are ordered. The form is completed and sealed correctly. That’s what a high-quality civil surgeon visit looks like. And it’s exactly what protects your application.

    Related reading: I-693 Exam: What St. Louis Applicants Must Know · Disclosing Chronic Conditions at the Immigration Exam · Civil Surgeon Objectivity: Why the Exam Feels Cold · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis

    Frequently Asked Questions

    Will the civil surgeon evaluate my general health?

    No. The I-693 screens only for conditions named by immigration law. Your general health is not judged. No health advice is part of the filing.

    Can common conditions like high blood pressure fail the exam?

    No. Chronic (long-term) conditions like hypertension, diabetes, or arthritis are not health-related grounds of inadmissibility.

    Why does the exam feel so impersonal?

    Because it’s a checking process, not a care visit. That discipline is what keeps your filing clean. Your own doctor is still the right person for health advice.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • Understanding TB in Your Immigration Medical Exam: Why Precision Beats the Assembly Line

    Understanding TB in Your Immigration Medical Exam: Why Precision Beats the Assembly Line

    Immigration Medical Exam: Understanding TB — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    TB screening in the immigration medical exam takes judgment. A positive IGRA (a TB blood test) has to be read against your BCG history, prior imaging, treatment records and current CDC technical instructions. Dr. Gurpreet Singh Padda, MD, MBA, MHP reviews every TB result himself. So prior positive tests are checked against your records, not re-tested by reflex.

    Your immigration journey is the change of your entire life. At the final medical hurdle, precision matters more than speed.

    Why does rushed TB screening cause immigration exam problems?

    Some clinics treat immigration medical exams as volume work. Get the applicant in, check the boxes, move to the next. TB screening is exactly where that approach breaks down. Tuberculosis evaluation takes judgment. A positive IGRA has to be read against BCG history, prior imaging, treatment records, and CDC technical instructions that are updated regularly. A rushed reading creates needless chest X-rays at best. At worst, it creates a rejected filing.

    How is a positive TB test reviewed at our clinic?

    At our Woodson clinic, Dr. Padda reviews every TB result himself, in light of your full history. Prior positive tests are checked against your records, not re-tested by reflex. When imaging is required, we set up the prepaid chest X-ray directly. The radiology report goes into your I-693 before it’s sealed. One clean file, one closed loop.

    What can I do to make TB screening go faster?

    Bring your history. Prior TB tests, X-ray reports, treatment records, and BCG vaccine history all change how fast your evaluation wraps up. The applicants who move through fastest aren’t the luckiest. They’re the best documented.

    Related reading: Gonorrhea & Syphilis Testing in the I-693 Process · I-693 Exam: What St. Louis Applicants Must Know · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis

    Frequently Asked Questions

    Why does TB screening cause so many green card delays?

    Because reading the result needs history. Without prior records, a positive result starts the whole chain over from zero. That means testing, imaging, and documentation again.

    TB Testing Is Where Green Card Exams Stall — Don’t Walk In Blind explains why TB testing is where so many exams stall.

    Does the clinic arrange the chest X-ray if I need one?

    Yes. When imaging is required, we set up a prepaid chest X-ray. We put the radiology report directly into your sealed I-693.

    What a positive result means, and when a chest X-ray follows, is covered in TB Testing and Treatment in the I-693 Exam: What St. Louis Applicants Must Know.

    Is a history of treated TB a problem for my application?

    Documented, completed treatment is a fact we can resolve. The exam’s purpose is to confirm there is no active disease. It is not to penalize medical history.

    What happens if my TB test is positive for immigration?

    A positive IGRA starts an evaluation, not a denial. Dr. Padda reads the result himself. He weighs it against your BCG history, any prior imaging, your treatment records and current CDC technical instructions. When a chest X-ray is required, we set it up. We fold the radiology report into your I-693 before the form is sealed. So the whole file closes as one clean loop.

    How do I prove my TB status for the I-693?

    With paper. Bring every prior TB test result, chest X-ray report, record of TB treatment and your BCG vaccination history. Prior positive tests are checked against those records, not re-tested by reflex. Without records, a positive result restarts the chain of testing, imaging and documentation from zero. That is where the weeks go.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • Gonorrhea and Syphilis Testing in the I-693 Process: Who Gets Tested and Why

    Gonorrhea and Syphilis Testing in the I-693 Process: Who Gets Tested and Why

    Gonorrhea & Syphilis Testing in the I-693 Process — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    The I-693 exam includes a syphilis blood test and a gonorrhea urine test, as CDC technical instructions require. A positive result is a treatable finding, not a permanent bar. With documented, completed treatment, the application can proceed.

    All green card applicants within specific age ranges must be tested for certain sexually transmitted infections. Knowing why takes the fear out of the process.

    Which STD tests does the immigration medical exam require?

    The CDC technical instructions set who gets tested. Applicants age 18–44 are tested for syphilis (a blood test). Those age 15 and older are screened for gonorrhea (a urine test). These aren’t judgments about you. They’re the communicable-disease (contagious disease) screenings that federal law designates for immigration.

    What happens if my syphilis or gonorrhea test is positive?

    A positive result is a treatable finding, not a permanent bar. Gonorrhea and untreated syphilis are both Class A conditions. But that is only while untreated. Once treatment is completed and documented, the finding is reclassified. Then the application proceeds. The worst plan is to avoid it. An untreated infection found late in the process causes far more delay than one dealt with directly.

    Privacy and Professionalism

    These results are kept as private as any medical record. They go into your sealed I-693 as clinical data points. Nothing more. Our office runs the required panels as prepaid, coordinated testing. That way results come back quickly and the file closes cleanly.

    Related reading: TB Testing and Treatment in the I-693 Exam · TB Screening in the Immigration Medical Exam · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis

    Frequently Asked Questions

    Who has to be tested for syphilis and gonorrhea in the I-693 exam?

    The CDC technical instructions set the ages. Syphilis blood testing applies to applicants 18–44. Gonorrhea urine screening applies to those 15 and older.

    Will a positive STI test make me inadmissible?

    Not permanently. These are Class A conditions only while untreated. Once you finish treatment and it is documented, the finding is resolved. Then your application proceeds.

    Are my results confidential?

    Yes. Results are medical records. They are kept private. They are included only within your sealed I-693, as required by USCIS.

    Is the USCIS medical exam checked for STDs?

    Yes. The CDC technical instructions set this. Applicants age 18 to 44 have a syphilis blood test. Those 15 and older have a gonorrhea urine test. These are not judgments about you. They are the communicable-disease screenings that federal law designates for immigration. The results go into your sealed I-693 as clinical data points. They are kept as private as any medical record.

    How much does the I-693 exam cost?

    The I-693 exam at our St. Louis office is $390, and a follow-up visit is $190. Say a syphilis or gonorrhea result comes back positive. It is a treatable finding, not a permanent bar. Once treatment is completed and documented, the finding is reclassified and your application proceeds. Dealing with it directly costs far less time than avoiding it.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • The I-693 Exam: What Every St. Louis Green Card Applicant Must Know Before Booking

    The I-693 Exam: What Every St. Louis Green Card Applicant Must Know Before Booking

    What St. Louis Green Card Applicants Must Know — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    Form I-693 is the medical exam USCIS requires of every adjustment-of-status applicant. A designated civil surgeon does it. It is limited to communicable diseases, required vaccinations, certain mental health conditions and substance abuse. Most delays come from missing vaccine records, TB testing and incomplete papers.

    The I-693 immigration medical exam is one of the last hurdles before your green card. It is also one of the easiest places to lose weeks to a mistake you could have stopped.

    What is the I-693 medical exam?

    USCIS requires every adjustment-of-status applicant to complete Form I-693. It is a medical exam done by a designated civil surgeon. The exam checks only for the things immigration law cares about. Those are certain communicable diseases, required vaccinations, mental health conditions associated with harmful behavior, and substance abuse. It is not a physical. Your general health is not being graded.

    What are the most common reasons I-693 exams get delayed?

    Vaccinations. The CDC’s immunization requirements for immigration are stricter than the usual adult shot schedule. They are more specific, too. The usual problem is missing paperwork, not missing immunity. Bring every vaccine record you have, in any language.

    Tuberculosis testing. All applicants age 2 and older require TB screening. This is typically an IGRA blood test. A positive result triggers a chest X-ray and more paperwork. Do you have a history of BCG vaccination or a prior positive test? Bring those records.

    Incomplete personal documents. You’ll need a government photo ID and your vaccination records. Bring any medical history for long-term (chronic) conditions too. Good records can turn many visits into a single one.

    How should I prepare for the I-693 medical exam?

    Gather your records first. Book second. Applicants who arrive with a complete file routinely finish faster. They avoid the follow-up loop entirely. Not sure your records are enough? Text our office before your visit. A two-minute question can save two weeks.

    Related reading: USCIS Medical Exam Is Not a Physical: What It Is · Vaccination Gaps: The #1 Cause of I-693 Delays · I-693 Exam Money-Back Guarantee in St. Louis · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis

    Frequently Asked Questions

    Do I need an appointment for the I-693 exam?

    Yes. Booking ahead lets us check what papers you need in advance. That way we can complete most exams in a single visit.

    What should I bring to my immigration medical exam?

    Bring a government photo ID and all vaccination records in any language. Bring any prior TB test results. Bring papers for any chronic medical conditions. Include a list of the drugs you take now.

    Which TB records to bring, and why they matter, is covered in TB Testing and Treatment in the I-693 Exam: What St. Louis Applicants Must Know.

    How long does the I-693 process take?

    With complete records, the exam itself takes under an hour. Lab results typically come back within days. Then the sealed I-693 is prepared for your application.

    What medical tests are done for the I-693?

    The exam checks only what immigration law cares about. That means certain communicable diseases, required vaccinations, mental health conditions associated with harmful behavior, and substance abuse. It is not a physical, and your general health is not graded. Every applicant age 2 and older is screened for TB. This is typically done with an IGRA blood test. A positive result leads to a chest X-ray.

    How much does the I-693 exam cost?

    The I-693 exam at our St. Louis office is $390, and a follow-up visit is $190. Arrive with a complete file: government photo ID, every vaccine record you have in any language, and any prior TB test results. That is how applicants routinely finish faster and avoid the follow-up loop.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    TB Testing Is Where Green Card Exams Stall — Don’t Walk In Blind explains why so many exams stall at TB testing.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.

  • The Only 100% Money-Back Guarantee on Immigration Medical Exams in St. Louis

    The Only 100% Money-Back Guarantee on Immigration Medical Exams in St. Louis

    100% Money Back Guarantee: Your Immigration Medical Exam Success Assured — Dr. Gurpreet Singh Padda, MD, MBA, MHP

    If USCIS rejects your I-693 solely because of a paperwork error made by our team, we refund your exam fee in full, provided you met all vaccination and testing requirements, supply the official USCIS rejection letter, and have no other errors in your green card application.

    Your green card application is too important to trust to an assembly line. So we back every I-693 exam with something no one else in the St. Louis area offers: a 100% money-back guarantee.

    Why offer a money-back guarantee on the I-693 exam?

    The I-693, Report of Medical Examination and Vaccination Record, is one of the few documents in your green card application where a third party controls the quality of the filing. That third party is the civil surgeon. Say the form is completed carelessly, sealed improperly, or documented incompletely. Then the applicant pays the price in delays, Requests for Evidence, or outright rejection. We believe the party who makes the error should bear the cost.

    Our guarantee is simple: if your I-693 is rejected by USCIS solely because of a paperwork error made by our team, and you met all vaccination and testing requirements, and you can provide the official USCIS rejection letter, and there are no other errors elsewhere in your green card application — you get your exam fee back. Every dollar.

    Who completes and seals your I-693?

    A guarantee like this only works when the process behind it is built for precision. Dr. Gurpreet Singh Padda, MD, MBA, MHP, a USCIS-designated civil surgeon, completes every form. Each one is checked against current USCIS and CDC technical instructions. Each one is sealed according to protocol. We treat the I-693 as what it is: a federal compliance filing. It is not a routine office visit with a form stapled to it.

    Applicants tell us the guarantee changes how the whole visit feels. They no longer wonder whether their paperwork is being handled correctly. They know the clinic has put its own money behind the answer.

    Related reading: I-693 Exam: What St. Louis Applicants Must Know · Why USCIS Rejects Most N-648 Disability Waivers · How to Spot an N-648 Mill: 5 Red Flags

    Frequently Asked Questions

    What does the money-back guarantee cover?

    If USCIS rejects your I-693 solely due to a paperwork error made by our team, you met all vaccination and testing requirements, you provide the official USCIS rejection letter, and no other errors exist in your green card application, your exam fee is refunded in full.

    How much does the I-693 immigration medical exam cost in St. Louis?

    Our I-693 exam is $390, with follow-up visits at $190. Lab testing and imaging, when required, are priced separately. See the complete I-693 immigration medical exam cost breakdown. It shows what is billed separately and when each amount is due.

    Where is the exam performed?

    At 4477 Woodson Rd, Suite 102, St. Louis, MO 63134. We are minutes from St. Louis Lambert International Airport, and we serve the entire St. Louis metro area.

    What are the common reasons for I-693 rejection?

    The I-693 is one of the few documents in a green card application where a third party, the civil surgeon, controls the quality of the filing. Say the form is completed carelessly, sealed improperly or documented incompletely. Then the applicant pays the price in delays, Requests for Evidence or outright rejection. That is why every form here is checked against current USCIS and CDC technical instructions before it is sealed.

    Watch the full video above, and explore the rest of the series on our YouTube channel.

    Schedule Your Exam in St. Louis

    Schedule Your Exam  Text (314) 886-5902  Call (314) 960-9100

    Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
    4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
    🌐 ImmigrationExam.us
    🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays

    💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400

    This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.

    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.