Before we start, a big thank you to our wonderful contributors: Ahmed, Andreas, Antonia, Bogdan, Christina, Greg, Iasmina, Jesh, and Sara. Your ideas have made this guide even better for our community!
So you’ve been selected in the Diversity Visa (DV) Lottery – congratulations! 🎉 One of the last hurdles on your journey to a green card is the immigration medical exam. This exam is a mandatory health check for all DV Lottery winners (and their family members) before obtaining the immigrant visa or green card. Don’t worry – we’re here to walk you through every step in a friendly, community-oriented way. In this guide, we’ll cover what the DV Lottery medical exam is, why it’s required, when and how to schedule it (with key differences for adjustment of status vs. consular processing), how to find an approved doctor, what documents and vaccines you need, what to expect during the exam, typical costs around the world, what if you’re missing a vaccine or test, how the results are submitted, common mistakes to avoid, and tips to stay organized and stress-free. Let’s get started on demystifying the medical exam process so you can approach it with confidence!
What Is the DV Lottery Medical Exam (and Why Is It Required)?
The DV Lottery medical exam is a standard immigration health examination that every diversity visa selectee must undergo as part of the green card process. It’s required by U.S. law (the Immigration and Nationality Act) to ensure you don’t have certain health conditions that would make you “inadmissible” to the United States. In plain language, the U.S. wants to confirm that new immigrants don’t pose a public health risk (for example, active tuberculosis or other communicable diseases) and meet vaccination requirements to protect everyone’s well-being. Think of it as a health screening, not a full physical. A doctor authorized by the U.S. government will check your medical history, perform a basic physical exam, and run a few specific tests (we’ll detail those later). This is not meant to judge you or deny you a visa for minor health issues – it’s mostly to catch serious communicable diseases or conditions of public health concern. Passing the medical exam is usually straightforward if you follow the requirements, and it’s a necessary step before your immigrant visa can be issued or your status adjusted to permanent resident.
When to Schedule Your Medical Exam (Timing: AOS vs. Consular)
DV Selectees Applying from Outside the U.S. (Consular Processing)
- Schedule After Interview Appointment:
If you will have your interview at a U.S. embassy or consulate abroad, you should only schedule the medical exam after you receive your interview appointment date. In DV Lottery terms, this means after you get the email or notice (often called the “2NL” – second notification letter) with your scheduled interview date, time, and location. - Time-Sensitive Results:
Do not rush to do the medical exam before your interview is scheduled, as the results are time-sensitive. In fact, the U.S. State Department instructs visa applicants NOT to do the exam until you know your interview date. - Ideal Timing:
Once you have your interview appointment, book your medical exam as soon as possible – ideally a few weeks before the interview. This gives the panel physician enough time to complete any tests and prepare your results by interview day. Remember, you must complete the medical exam (including any required vaccinations) before your visa interview date. - Validity Period:
Medical reports are generally valid for 6 months for immigration purposes (or 3 months in certain medical cases), so timing it within a month or two of the interview is usually safe. Avoid scheduling it too early (results might expire) or waiting until the last minute (in case additional tests are needed).
DV Selectees Applying from Within the U.S. (Adjustment of Status – AOS)
- USCIS-Certified Civil Surgeon Required:
If you are legally in the U.S. and adjusting status through USCIS, you will need a USCIS-certified civil surgeon to do your exam. As of late 2024, USCIS now requires adjustment applicants to submit the medical exam results (Form I-693) with the green card application (Form I-485). - Schedule Before Filing:
Schedule and complete your medical exam shortly before you file your AOS application, so that you can include the sealed I-693 medical form in the same packet. If you fail to include the medical, USCIS may reject your entire I-485 application for being incomplete. - Tight Timing:
For DV Lottery AOS candidates, timing is tight because all processing (including submitting the exam and being approved) must happen by September 30 of the DV program year. Ideally, schedule your exam a few weeks before you intend to file AOS, or as soon as your DV rank number is current and you’re ready to submit the I-485. - Exam Validity:
The exam report signed by the doctor will remain valid throughout your AOS process (with recent updates extending the validity of medicals signed after November 2023 indefinitely for current applications). Just ensure the exam is done no earlier than 60 days before filing.
Key Point: For both consular and AOS, do not procrastinate. As soon as you have the go-ahead (interview scheduled for consular, or eligible to file for AOS), plan your medical exam. This way, you avoid last-minute stress or potential delays. Remember, no medical exam = no visa or green card, so timing this right is just as important as showing up to the interview on time!
Finding an Approved Doctor (Civil Surgeon vs. Panel Physician)
You can’t just go to your usual family doctor for this exam – you must use an approved physician who is authorized to conduct U.S. immigration medical exams. There are two types of authorized doctors:
Civil Surgeons (for Inside the U.S.)
- For Adjustment of Status:
These are physicians designated by USCIS to perform immigration exams for adjustment of status applicants. If you’re doing AOS, you will need to find a civil surgeon near you. USCIS provides a handy “Find a Doctor” tool on their website or you can call the USCIS Contact Center for assistance. - Verify Credentials:
It’s a good idea to call around to a few civil surgeons to ask about availability and fees – prices can vary. When you call, mention that you need an immigration medical exam for a green card so they know exactly what you’re requesting. Make sure the doctor is indeed a USCIS-designated civil surgeon in good standing; using a non-authorized physician will cause USCIS to reject your medical exam.
Panel Physicians (for Outside the U.S.)
- For Consular Processing:
Panel physicians are doctors approved by the U.S. Department of State and associated with U.S. embassies/consulates abroad. If you’re doing consular processing, you must go to one of the panel physicians specified by the embassy or consulate where you’ll have your interview. - Follow Embassy Instructions:
Typically, when you receive your DV interview notice, it will direct you to the embassy’s instructions for scheduling the medical exam. You must contact the panel physician yourself to schedule the appointment – the embassy won’t do it for you. - Communication:
When you call or email them, explain that you are a Diversity Visa applicant who needs an immigrant visa medical exam, and provide your interview date so they can schedule appropriately. - Double-Check:
It’s important to use only the doctors on the approved list; going to any other clinic will not count.
Pro Tip: Whether civil surgeon or panel physician, consider checking reviews or asking other immigrants/DV winners in your area about their experiences. An authorized doctor with a good reputation can make the exam smoother. Also, ask about the cost upfront and what it includes.
Documents and Vaccines: What to Prepare for Your Exam
Proper preparation will save you a lot of stress on exam day. Here’s a checklist of documents and items to gather before your medical exam appointment:
- Passport (or Government Photo ID):
This is crucial for identity verification. Bring your passport (or driver’s license/state ID if the exam is in the U.S.) to the exam. The doctor will use it to confirm your identity and fill out your info on the forms. - Interview Appointment Letter (Consular Applicants Only):
The panel physician will often want to see your appointment notification or case number to verify that you are a legitimate DV applicant and to know where to send the results. Bring a printout of your interview appointment email/letter or have your DV case number handy. - Form I-693 (for AOS, if Required):
If you’re seeing a civil surgeon in the U.S., you might download Form I-693, Report of Medical Examination and Vaccination Record, from USCIS and fill out the patient information part (Part 1) ahead of time. Do not sign it until the doctor instructs you. - Vaccination Records (Immunization Card or History):
This is super important! One big part of the exam is confirming you have had all required vaccinations for U.S. immigration. Gather any records of vaccinations you have received in your life – childhood immunization cards, hospital records, or doctor printouts. The doctor will review your documents to verify which vaccines you’ve had and which you might still need.
(As of early 2025, COVID-19 vaccination is no longer required for immigration exams, so you can breathe a bit easier on that one.) - Medical History Documents:
If you have any ongoing medical conditions, prior serious illnesses, or previous positive tests (like a past positive TB skin test or treatment for syphilis), bring documentation about it. For example, if you had tuberculosis in the past or a positive TB test, bring a certificate or letter from your doctor detailing the diagnosis, treatment, and outcome. Similarly, if you have ever had syphilis, bring documentation showing you were adequately treated. If you have chronic conditions such as diabetes or high blood pressure, a short summary from your doctor about your status and treatment can be helpful. - Previous Chest X-ray Images (if Available):
If you have an old chest X-ray and have had issues like TB, bring the film or CD. - Passport-Size Photos:
Some doctors (especially panel physicians) require a couple of passport-style photos for their medical report forms. Check the specific instructions from your embassy or doctor. - Payment & Money:
The exam fee is paid directly to the doctor or clinic – not to the embassy or USCIS. Bring the accepted form of payment (cash is common; some places may accept credit/debit). Confirm the fee in advance and be prepared with extra funds in case additional vaccines or tests are needed. - Glasses or Contacts:
If you wear prescription glasses or contact lenses, bring them along as the doctor might need you to do a quick vision test.
Organize all these items the night before your appointment. Having everything ready in a dedicated folder will keep you calm and ensure you don’t forget anything!
What to Expect During the Medical Exam
Walking into the medical exam can be a bit nerve-wracking if you’re not sure what will happen. The process is generally routine, and the physicians are friendly and professional. Here’s a step-by-step rundown:
- Check-In and Paperwork:
When you arrive at the clinic, you’ll check in and show your passport (and interview letter if you’re overseas). You may need to fill out a form about your medical history, including any past surgeries, illnesses, or medications. Answer honestly and thoroughly—remember, the exam’s purpose is to ensure public health safety, not to find reasons to reject you for minor issues. - Review of Documents and Vaccination Records:
A nurse or the doctor will review your vaccination records and medical paperwork. They’ll compare your vaccination history against the U.S. requirements. If you’re missing any vaccines, they’ll let you know and may offer to administer the vaccine during the exam. - Physical Examination:
The physician will do a basic physical exam—checking your eyes, ears, nose, throat, heart, lungs, abdomen, limbs, and skin. You might be asked questions about any tattoos, scars, or even a history of substance use or mental health treatment. Answer honestly; they need to note certain details for government requirements. - Specific Tests:
- Tuberculosis (TB) Screening:
You may be given a blood test (IGRA such as Quantiferon or T-Spot) to check for TB infection, or, in some cases, a TB skin test (PPD) might be used. If the initial test is negative, a chest X-ray might not be necessary unless indicated by symptoms or history.
Note: Some panel physicians may perform a chest X-ray for all adult applicants, but the trend is to do targeted X-rays only if needed. - Blood Test for Syphilis:
Applicants 15 years or older will have a blood test for syphilis. This is a simple blood draw. If you’re younger than 15, generally this test isn’t required unless there is a specific reason. - Urine Test for Gonorrhea:
A urine sample will be collected to test for gonorrhea for applicants 15 and older. Results are typically quick, and if positive, treatment will be required. - Additional Checks:
The doctor might also check your blood pressure and perform other routine examinations. There is no drug test for the DV medical exam, and an HIV test is no longer required.
- Tuberculosis (TB) Screening:
The duration of the exam can vary. The physical exam and review might take 15–30 minutes, with additional time for blood draws or an X-ray if necessary. If a TB skin test is administered, you will need to return in 48–72 hours for the reading. Often, you may leave without knowing all the results immediately—“no news is good news.”
Typical Costs of the Medical Exam (A Global Perspective)
One of the big questions is: How much will the DV medical exam cost? The answer depends on your country, region, and provider.
- Overall Range:
Most applicants worldwide pay somewhere between USD $100 and $500 per person for the exam. - Typical Averages:
Community reports suggest a typical cost around $200 per person for the basic exam. In some regions, fees may be lower (around $100–$150) or higher (up to $300–$400), depending on local economic conditions. - What the Fee Covers:
The base fee generally covers the exam consultation and required tests (blood tests, urine test, and an X-ray if needed). Vaccinations are usually not included in the base fee and may cost extra. - Payment and Insurance:
Immigration medical exams are typically not covered by health insurance. In the U.S., some civil surgeons may accept insurance for parts of the exam (such as vaccinations or X-rays), but be prepared to pay out-of-pocket. Abroad, payment is usually by cash or credit card. - Country Examples:
- South Asia: Fees around $100–$200
- Eastern Europe: Approximately $200
- Western Europe/UK: Closer to $300
- USA: Typically between $250–$500 (with $300 being common in larger metro areas)
- Children’s Costs:
Children might pay slightly less if certain tests (like blood draws or X-rays) are not required, though vaccinations still apply. - Extra Costs:
Consider other expenses like travel to the doctor, potential additional vaccines, or extra tests if required.
Plan ahead financially, as the medical exam is one of the larger expenses in the DV process alongside visa fees and travel.
What If You’re Missing a Vaccine or Test Result?
It’s common to worry, “Uh oh, what if I don’t have proof of a certain vaccine?” or “What if one of my test results is positive?” Here’s what you need to know:
- Missing Vaccinations:
If you discover you haven’t had a particular vaccine on the required list, or you can’t find your records, don’t panic. The panel physician or civil surgeon will work with you to get you into compliance during your exam appointment. In many cases, you can receive the needed vaccine on the spot. - Medical Waivers for Vaccines:
If a vaccine is medically contraindicated (for example, during pregnancy or due to specific allergies or immune conditions), the physician can mark on your form that it is not appropriate. There are also age exemptions for certain vaccines. If you simply don’t want a vaccine without a valid reason, you would have to apply for a waiver on religious or moral grounds. - Positive TB Test or Abnormal X-ray:
If your TB test comes back positive, it might indicate latent TB or a false positive. The next step is typically a chest X-ray to determine if there is active TB. If the X-ray is normal, you might receive a notation for latent TB but still be cleared for immigration. If the X-ray is abnormal, further tests (such as sputum cultures) may be required, potentially delaying your visa process. - Positive Syphilis or Gonorrhea Test:
If your blood test is positive for syphilis or your urine test indicates gonorrhea, you will need treatment (usually antibiotics) and documentation showing you have been treated before your medical exam can be approved. - Other Health Issues:
Chronic conditions like diabetes or high blood pressure generally do not affect visa eligibility if managed properly. However, incomplete or false information can cause delays or even visa refusal. - Incomplete Exam or Missing Documents:
Failing to bring required documents (like your passport or vaccination record) may force you to provide them later or reschedule your exam.
How the Medical Results Are Submitted
After you’ve completed the exam and any necessary follow-ups, the doctor will compile your results into the official format for immigration. The process differs based on your application type:
For Consular Processing (Interview Abroad)
- Sealed Envelope or Electronic Submission:
The panel physician will either give you a sealed envelope with your medical exam results or send the results directly to the U.S. Embassy/Consulate. Do NOT open the envelope—the seal assures the embassy that the results are authentic and untampered. - Electronic Systems:
In some cases, the results are sent electronically (via an eMedical system). Even if you do not receive a physical packet, confirm with your doctor if you need to bring any additional documentation, such as a CD of your chest X-ray.
For Adjustment of Status (Within the U.S.)
- Form I-693:
The civil surgeon will complete and sign Form I-693 (Report of Medical Examination and Vaccination Record) for you. The form and any supporting test reports will be placed in a sealed envelope with a signature or stamp across the seal. You are responsible for submitting this sealed envelope to USCIS along with your Form I-485. - Important Reminder:
Do not open the sealed envelope. USCIS will reject it if it appears to have been tampered with. If you didn’t include the I-693 when filing, you may face delays or a Request for Evidence.
Keep a note of your exam date—if more than 6 months pass without visa issuance, you might need to redo the exam since results expire after 6 months in most cases.
Common Mistakes to Avoid
Even with the best preparation, it’s easy to make mistakes in the medical exam process. Here are some common pitfalls:
- Waiting Too Long to Schedule the Exam:
For consular applicants, don’t wait until the week of your interview; for AOS applicants, don’t delay until the last minute before the filing deadline. Scheduling too early can also be problematic if the results expire. - Using a Non-Authorized Doctor:
Always choose a USCIS-designated civil surgeon or an embassy-approved panel physician. A full physical from your regular doctor will not suffice unless they are a certified civil surgeon. - Failing to Complete the Exam Before Filing (for AOS):
If you send in your Form I-485 without the sealed I-693, USCIS might reject your application as incomplete. - Forgetting Important Documents:
Ensure you bring your passport, vaccination records, photos, appointment letter, and any other required documentation. Forgetting any of these can cause delays. - Not Disclosing Your Medical History:
Be honest about your medical background. Omitting or falsifying information can lead to delays or even visa refusal. - Opening the Sealed Envelope:
For consular processing, do NOT open the sealed medical packet. Doing so may require you to get it re-sealed or even redo the exam. - Not Following Up on Additional Instructions:
If the doctor instructs you to return for a follow-up (such as a TB skin test reading or an extra vaccine dose), make sure you do so. - Being Unprepared for Payment:
Confirm the accepted form of payment in advance and bring the appropriate funds.
Tips for Reducing Stress and Staying Organized
Dealing with medical exams and visa paperwork can be stressful. Here are some friendly tips to help you stay calm, organized, and confident:
- Use a Checklist and Organize Your Documents:
Write down everything you need (passport, appointment letter, vaccine records, payment, etc.) and keep all your documents in a dedicated folder or envelope. - Educate Yourself Ahead of Time:
The more you know about what to expect, the less intimidating it will be. Read official instructions and learn from others in the DV community. - Schedule Smartly:
Choose an appointment time that gives you plenty of buffer—avoid days packed with other commitments. - Take Care of Yourself:
Get a good night’s sleep, eat a balanced meal beforehand, and wear comfortable clothing. Arrive early to reduce any stress of being late. - Bring Support if Needed:
If having a friend or family member nearby helps, see if you can bring someone along (if permitted) or have them meet you after the exam. - Keep Copies and Notes:
After your exam, jot down key details (date, doctor’s name, any follow-up instructions) and keep copies of any forms or receipts. - Financial Preparation:
Set aside the necessary funds ahead of time so payment issues do not add extra stress on the day of your exam. - Maintain a Positive Mindset:
Remember why you’re doing this—the medical exam is one step closer to your dream of moving to the U.S. Stay focused on your goal. - Engage with the DV Community:
Join forums or groups where DV lottery winners share their experiences. This can provide both guidance and reassurance. - Double-Check Embassy/Civil Surgeon Instructions:
Before the exam day, quickly review any specific instructions from the embassy or your civil surgeon to ensure you haven’t missed any requirements. - Stay Calm While Waiting for Results:
Trust that if there were serious issues, the doctor would inform you. “No news is good news” in most cases. - Celebrate Small Wins:
Once you complete your exam, treat yourself for reaching another milestone on your journey to a green card!
Remember, you’re not alone in this. Many of us in the immigration community have felt the same nerves, made the same preparations, and come out smiling on the other side. By staying organized and informed, you’re stacking the deck for a smooth medical exam experience. Keep friendly with the clinic staff, stay informed, and take it one step at a time. Before you know it, this will be behind you and you’ll be focusing on the next exciting steps of your journey. Good luck, and here’s to your healthy future in the United States!
Disclaimer
The information presented in this guide is for informational purposes only and does not constitute an official statement or representation by any government agency. The content is based on our research and is not verified by any official or governmental source. We make no guarantees regarding the accuracy or completeness of the information provided. Users should independently verify all details with official sources—such as travel.state.gov—before making any decisions based on this guide. By using this information, you agree that we are not liable for any errors or omissions, and that it should not be relied upon as legal or official guidance.