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Applicants for adjustment of status must have the forms I-693 and its supplemental filled out by a civil surgeon. Both Dr. Axelrod and Dr. Mirman are designated civil surgeons. We make every attempt to fill your forms out right so your immigration process goes smoothly. Our track record is very good, and many immigration attorneys refer their clients to us for the immigration physicals. Our job is to conduct the examination in the way that is the best and most cost-effective for you, and in full compliance with the USCIS regulations.
Here is what will happen when you come in for immigration physical:
First you will fill out some forms.
Then we will invite you into an exam room, where we will ask you some questions about your health and immunization status and do a physical exam.
Based on the results of the exam and your health history we will suggest certain procedures, including blood and urine tests, skin test, chest X-ray and immunizations.
Read the following to be able to better understand the process and possibly save money and aggravation.
Most health plans do not cover these services. You need to pay us directly and we can provide you with the formal insurance forms so you can bill them yourself. Some of our clients do get reimbursed, but we can't guarantee it.
If you have insurance and it may pay for some of the tests and immunizations you need, you can have them done at your primary care clinic. Then you can ask your doctor to give you copies of your records pertaining to these procedures and we will use them to prepare your immigration form.
Immunizations
You are required to be immunized completely according to the standard schedule. If you have any immunization records, whether American or from your home country, please bring them in. It is best to have them translated, but we can usually figure out even the foreign records and apply all your immunizations towards your INS requirements. Once we know which extra immunizations you need we can give them to you or you can have them done at your primary care doctor’s office.
Children under the age of 19 need the most shots, so please make sure you bring all the available records. We don’t want to give them more shots than they really need.
If you would like to limit the number of immunizations you get, we can do a blood test to verify your immunity to certain childhood illnesses (so called titer). If you test positive for the disease in question, you do not need a shot. The titers for most diseases are more expensive than the shots, so most people chose to just do the shots.
If you have had chicken pox (Varicella), you do not need a shot for it. If you don’t know if you have had it, ask your parents whether you did, and at approximately what age.
Lab tests.
The main blood test we do for syphilis. This is required for all applicants age 15 and older. If you choose to do titers for childhood illnesses, they are added to the same test and you don’t need an extra needle stick. Sometimes we need to add other tests (blood or urine) based on the exam findings.
Tuberculosis Testing.
Skin test for Tuberculosis (PPD or Mantoux) is required for everybody age 2 and up, unless you opt for Quantiferon Gold blood test for TB (see below).
If you have ever had a positive skin test, please let us know and get records to prove it. If you can't get the record, we may need to repeat the test and it will be positive again. It is not bad and will not affect your immigration process. If you have ever had a positive test, we should not repeat it, because it will be positive again and we will not gain any useful information. A positive test means you have had some exposure to TB or received BCG vaccine. Most people have had a vaccination for TB (BCG) in their early childhood, and it often renders them positive on the skin test for the rest of their life.
A positive test means that the area on your forearm that was injected with the “antigen” swells up a bit. Then the doctor would tell you the test is positive and send you for a chest X-ray. So, if you’ve ever had a skin test which was followed by a chest X-ray, the test was probably positive. It would be helpful for us to see the record of the test and the X-ray your doctor did.
In cases when the test was definitely positive in the past and we have a record to prove it, we go straight to chest X-ray, so you avoid an unnecessary needle stick with the following discomfort from the swelling on your forearm.
Another alternative is a blood test called Quantiferon Gold. This test distinguishes a positive skin test from BCG from one due to actual TB exposure. Sometimes it is preferable to other testing methods. For example, if your skin test is larger than 15mm, you may be required to receive TB prophylaxis with an anti-TB drug for 9 months. Quantiferon Gold test may indicate that the positive result is not due to TB exposure, and you will not need the treatment. Pregnancy is no longer a contraindication for the chest x-ray requirement. However, a negative Quantiferon Gold test makes x-ray unnecessary. We will help you decide which method is best and most cost-effective for you.
Our charges
Most of our immigration-related charges are listed below. You may want to call other clinics to compare. You can find all designated civil surgeons here: http://uscis.gov/graphics/surgeonportal.htm When comparing clinics, make sure to ask how long you may need to wait to get the appointment. We can usually see you and get the forms finished within a week, and in some cases two days is enough. We have the lab and x-ray facilities on premises and do everything needed right away.
Most adults should expect to pay around $300 for everything necessary. It could be a bit more or less depending on what is needed.
The
exam itself is $170 for adults and $150 for children under 15. PPD skin
test (for TB) is included.
This charge also includes all paperwork, including preparation of all the
necessary forms.
Everything else is added “a la carte”. We will suggest the procedures necessary for the preparation of your form. Our prices are very competitive because we negotiated a special deal on testing with our lab.
Here are some of the prices:
Chest X-ray: $70.00 Blood test for syphilis: $30.00, plus $8.00 blood draw fee (only one for all the blood tests together, in case you need any others) Quantiferon Gold blood test for TB: $100.00 Immunizations: $14 for administration if free vaccine is available from the MN Dept. of Health (only for children under 15), more if we have to buy it. The supplies vary depending on demand.
Refugee immunization forms (not for adjustment of status): $40.00
Again, if you can have the necessary testing and shots done elsewhere under insurance, do it and we will accept the records.
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