What is being tested in our Immigration panels?

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  • Quantiferon TB Gold Plus*
  • Gonorrhea
  • RPR (Syphilis)
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What is an immigration medical exam?

Under the Department of State, the US Citizenship and Immigration Services (USCIS) requires a physical exam from green card applicants. The Refugee Act of 1980 conferred certain responsibilities to the Centers for Disease Control and Prevention (CDC) and the Division of Global Migration and Quarantine (DGMQ). The CDC and DGMQ monitor the health status of refugees. To prevent the transmission of highly communicable diseases, these organizations evaluate the health of potential immigrants. This includes a review of medical screenings and immunization records. During the immigration process, certain medical conditions can be grounds for inadmissibility. The CDC focuses on conditions such as active MMR (measles, mumps, rubella), hepatitis A, hepatitis B, varicella, tetanus, diphtheria, and meningococcal and pneumococcal viruses.

Tuberculosis (TB), gonorrhea, and syphilis are common testing requirements. Those with immigrant visas seeking an adjustment of status to permanent residence require negative test results for these conditions. Though there are waivers for certain immunizations, screening for these diseases is obligatory.

Screening for Admissibility

An immigration medical examination provides the necessary documentation to certify health-related admissibility. Civil surgeons require, among other diseases, tuberculosis, gonorrhea, and syphilis screenings. Immigrant panels test for these factors simultaneously through limited collection methods. These panels reduce time, effectively manage resources, and deliver vital results.

What is measured in an immigration testing panel?

Using advanced technology, Access Medical Labs' immigration panels test for three infectious diseases. These diseases are prominent during medical examinations according to immigration law. They are tuberculosis, gonorrhea, and syphilis.


The US Embassy requires tuberculosis (TB) testing. As of October 2018, USCIS no longer accept tuberculin skin tests (TST), an older form of TB screening. TST involves additional time, equipment, and inconvenience for both civil surgeon and patient. Vitally, it presents a weakness to the Bacillus Calmette-Guérin (BCG) vaccine. The BCG vaccine is a common TB immunization outside of the United States. However, it has variable success against adult pulmonary tuberculosis. It is not recommended in the United States, and it does not meet the vaccination requirements for an immigration exam.

Nevertheless, BCG vaccinations are common in many foreign-born persons. The BCG vaccine may cause a false positive result on a tuberculin skin test. Likewise, other testing methods present challenges. A chest x-ray, for example, may aid in diagnosis but fails as an effective screening method. Alternatives are therefore required for United States immigration testing.

Blood testing for tuberculosis has become the industry standard. Access Medical Labs is equipped with cutting-edge TB testing technology: QuantiFERON TB Gold Plus. QuantiFERON measures a cellular response to the M. Tuberculosis strain. High levels indicate the presence of the tuberculosis virus. Interferon-gamma (IFN-γ) enzyme-linked immunosorbent assay (ELISA) is a widely-used form of interferon-gamma release assay (IGRA). Access Medical Labs uses chemiluminescence immunoassay (CLIA) for TB testing. CLIA has a higher level of specificity and sensitivity than traditional ELISA.


Gonorrhea is often asymptomatic, yet it results in considerable long-term consequences. If undetected and untreated, gonorrhea could lead to ectopic pregnancy, infertility, and pelvic inflammatory disease (PID). Therefore, immigration physical exams require gonorrhea screening. According to the CDC, all applicants aged 18-24 must submit to gonorrhea testing. Applicants outside of that age range must submit to testing if gonorrhea infection is suspected for any reason.

The asymptomatic nature of gonorrhea presents a potential roadblock. The CDC calls for three components during immigration medical screening. These include a physical examination, a medical history, and a nucleic acid amplification test (NAAT). For the NAAT, samples from the infected area are valuable. Urine samples are highly effective for the NAAT, making urine testing on par with urethral or cervical swabs. Additionally, urine testing reduces potential discomfort or embarrassment for patients. For highly-specific, convenient, and reliable gonorrhea testing, Access Medical Labs’ gonorrhea testing requires a urine sample.


Syphilis has many different clinical presentations. To navigate syphilis testing for immigration medical exams, civic surgeons require effective screenings. As well as a physical examination and a medical history, the CDC requires syphilis laboratory testing. AML uses rapid plasma reagin (RPR) for syphilis testing on their immigration panel. As with gonorrhea testing, RPR tests for syphilis reagin antibodies in the plasma and serum. With a high level of sensitivity, RPR meets the requirements for the green card medical exam and the CDC’s requirements for a nontreponemal syphilis test.

Which immigration medical exam do I need?

To prove admissibility on public health grounds, the USCIS requires the I-693 form. Form I-693 is a report of medical examination and vaccination records. It includes screening requirements for tuberculosis, gonorrhea, and syphilis.

Access Medical Labs offers blood and urine testing for immigration screening. With the most accurate and sensitive testing practices, our panels provide the data you and your patient need to complete Form I-693. AML's immigrant testing panels provide government-mandated diagnostics to prevent the spread of infectious diseases. Additionally, these test results can provide potential immigrants with necessary urgent care.

What is the immigration testing panel process?

All blood and urine samples must be collected at a doctor’s office, clinic, or hospital, under the care of a designated civil surgeon or panel physician. Be sure to follow technical instructions for sample collection. Once your sample is received in our laboratory, our team of highly-trained lab technologists will analyze the sample and send the results to you within 48 hours. Find additional information on AML’s immigration testing here.

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