A brief overview of the role of the civil surgeon and a list of USCIS-designated medical providers in North Dakota who can complete and sign off on the I-693 medical immigration exam.
Understanding the Role of the Civil Surgeon and Adjustment of Status for Refugees
Refugees who have been physically present in the U.S. for one year may complete medical evaluations (examination) to adjust their status and obtain a “green card” or legal permanent residence status. The medical evaluation for refugees differs from that of immigrants; therefore, confirming the individual's legal status is critical before proceeding.
The medical immigration examination must be completed by a civil surgeon (a physician designated by U.S. Citizenship and Immigration Services or USCIS) or their designee. The medical director of local public health may complete the form for applicants through a blanket waiver designation with refugee status only. This blanket waiver designation does not extend to asylees or Cuban/Haitian/Afghan parolee applicants, nor does it extend to any other applicant for adjustment of status. Regardless of the status, the USCIS Form I-693 must be completed, signed, and submitted in a sealed envelope for all applicants.
Validity of the USCIS Form I-693
USCIS generally considers a completed Form I-693 to retain its evidentiary value for two years after the date the civil surgeon signed it. USCIS has removed the requirement that the applicant submit their underlying immigrant benefit application no more than 60 days after the civil surgeon's signature on Form I-693. Effective April 4, 2024, any Form I-693 that was properly completed and signed by a civil surgeon on or after Nov. 1, 2023, does not expire, and can be used indefinitely as evidence to show that the applicant is not inadmissible on health-related grounds.
Note: Under certain circumstances, USCIS may provide all applicants temporary waivers from the aforementioned requirements.
For Refugees
- Refugees who arrived to the U.S. without a Class A condition will be required to update vaccinations only. The civil surgeon or the public health designee must complete the I693 Form, Part 10. Vaccination Record.
- Refugees who only need to complete the vaccinations, must complete and submit the following sections of the I-693 form.
- Part 1: Information about you.
- Part 2: Applicant’s statement, contact information, certification, and signature.
- Part 3: Interpreter’s contact information, certification, and signature- If interpreter is utilized.
- Part 4: Contact information, declaration, and signature of the person preparing the application, if other than the applicant.
- Part 5: Applicant’s identification information.
- Part 7: Civil surgeon’s contact information, certification, and signature.
- Part 10: Vaccination record
- Refugees who arrived to the U.S. with a Class A condition must complete the entire medical immigration examination, including vaccinations. The examination must be conducted by a civil surgeon.
For Immigrants, including Asylees and Parolees
- A complete medical immigration examination is required by a civil surgeon.
North Dakota Civil Surgeons List:
Note: The exam and administrative fees are not covered by insurance and vary between civil surgeons. Contact the clinic for details.
Family Health Care
Dr. Napoleon Espejo
301 NP Avenue
Fargo, ND, 58102
(701) 271-3344
Essentia Health Clinic
Dr. John Mickelson
1100 19th Avenue N
Fargo, ND, 58102
(701) 364-5757
UND Center for Family Medicine
Dr. Jeffrey Hostetter
701 E. Rosser Avenue
Bismarck, ND, 58501
(70) 751-9500
Sanford North Mandan Clinic
Dr. Krissondra Klop
910 18th St NW
Mandan, ND, 58554
(701) 667-5100
Trinity Medical Group, Health Center- Medical Arts
Dr. Howard Reeve
400 E. Burdick Expressway
Minot, ND, 58701
(701) 857-7840
For more information:
I-693, Report of Medical Examination and Vaccination Record
CDC Technical Instruction for Civil Surgeons- Medical History and Physical Examination
CDC Technical Instructions for Civil Surgeons- Vaccinations
CDC Technical Instructions for Civil Surgeons- Tuberculosis