Medical Examination of Aliens Seeking Adjustment of Status:

Dr.Ali is certified civil surgeon designated by the United States Citizenship and Immigration Services(USCIS) Immigration exam can be performed within 1-2 days after making the appointment. Since we are open 9am to 9pm seven days a week we can perform your exam at a time which suits your schedule.

The examination fees is $300.00 which includes the following:

  • Physical exam by our civil surgeon.
  • Blood test for TB (age 2 years and up).
  • Chest X-Ray if TB blood test is positive.
  • Blood test for Syphilis (age 15 years and up).
  • Urine test for Gonorrhea (age 15 years and up).
  • Discussing and recommending vaccination requirements for the completion of your I-693 form.
  • Sealing the completed I-693 form in our secure envelope.
  • Communicating and providing any further information to the USCIS after you submit your completed I-693 form.

Generally it takes about 5 days to get all the above steps completed.

Examination fees is $150.00 if you have already done your Blood test for TB and Syphilis plus Urine test for Gonorrhea through your family doctor and all the results are negative.

If you already had an immigration exam done by another civil surgeon and USCIS wants you to get your vaccination form to be completed then our professional fee is $98.00.

Vaccination Requirements:

By law, for the immigration physical exam the required vaccines include:

  1. Mumps, measles,rubella (MMR).
  2. Polio.
  3. Tetanus and diphtheria toxoids (Tdap).
  4. Influenza.
  5. Hepatitis A.
  6. Hepatitis B.
  7. Chickenpox (varicella).
  8. Pneumococcal.
  9. Rotavirus.
  10. Meningococcal.

Any other vaccinations recommended by the Advisory Committee for Immunization Practices (ACIP). If you never received or are unable to prove that you received certain vaccines, we can administer them to you at an additional cost.

Requirements for Immigration Physical:

When you are coming for your immigration exam please remember to bring the following items with you.

  1. Passport.
  2. Photo ID.
  3. Proof of your vaccinations if available.

To make an appointment for your Immigration exam please call us on any of the following locations:
Ann Arbor: 734-995-8888
Brighton: 810-225-0086
Hartland: 810-632-0086
South Lyon: 248-437-0086

Required Vaccines


If you want to know more about MMR Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Measles, mumps, and rubella are serious diseases.

Measles:

  • Measles virus causes rash, cough, runny nose, eye irritation, and fever.
  • It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage, and death.

Mumps:

  • Mumps virus causes fever, headache, and swollen glands.
  • It can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and, rarely, death.

Rubella (German Measles):

  • Rubella virus causes rash, mild fever, and arthritis (mostly in women).
  • If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.

You or your child could catch these diseases by being around someone who has them. They spread from person to person through the air.

Who should get MMR vaccine and when?

Children should get 2 doses of MMR vaccine:

  • First Dose: 12–15 months of age
  • Second Dose: 4–6 years of age (may be given earlier, if at least 28 days after the 1st dose)

Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country. (This dose will not count toward their routine series.)

Some adults should also get MMR vaccine:
Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases.

MMR vaccine may be given at the same time as other vaccines.

Children between 1 and 12 years of age can get a “combination” vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines. There is a separate Vaccine Information Statement for MMRV.

If you want to know more about MMR Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Polio Click here for further Vaccine Information Statement (VIS).

Polio is a disease caused by a virus. It enters the body through the mouth. Usually it does not cause serious illness. But sometimes it causes paralysis (can’t move arm or leg), and it can cause meningitis (irritation of the lining of the brain). It can kill people who get it, usually by paralyzing the muscles that help them breathe.

Polio used to be very common in the United States. It paralyzed and killed thousands of people a year before we had a vaccine.

Why get vaccinated?

Inactivated Polio Vaccine (IPV) can prevent polio.
History: A 1916 polio epidemic in the United States killed 6,000 people and paralyzed 27,000 more. In the early 1950’s there were more than 25,000 cases of polio reported each year. Polio vaccination was begun in 1955. By 1960 the number of reported cases had dropped to about 3,000, and by 1979 there were only about 10. The success of polio vaccination in the U.S. and other countries has sparked a world-wide effort to eliminate polio.

Today: Polio has been eliminated from the United States. But the disease is still common in some parts of the world. It would only take one person infected with polio virus coming from another country to bring the disease back here if we were not protected by vaccine. If the effort to eliminate the disease from the world is successful, some day we won’t need polio vaccine. Until then, we need to keep getting our children vaccinated.

Who should get polio vaccine and when?

IPV is a shot, given in the leg or arm, depending on age. It may be given at the same time as other vaccines.

Children: Children get 4 doses of IPV, at these ages:

  • A dose at 2 months
  • A dose at 4 months
  • A dose at 6-18 months
  • A booster dose at 4–6 years

Some “combination” vaccines (several different vaccines in the same shot) contain IPV.

Children getting these vaccines may get one more (5th) dose of polio vaccine. This is not a problem.

Adults: Most adults 18 and older do not need polio vaccine because they were vaccinated as children. But some adults are at higher risk and should consider polio vaccination:

  • people traveling to areas of the world where polio is common,
  • laboratory workers who might handle polio virus, and
  • health care workers treating patients who could have polio.

Adults in these three groups:

  • who have never been vaccinated against polio should get 3 doses of IPV:
    • Two doses separated by 1 to 2 months, and
    • A third dose 6 to 12 months after the second.
  • who have had 1 or 2 doses of polio vaccine in the past should get the remaining 1 or 2 doses. It doesn’t matter how long it has been since the earlier dose(s).
  • who have had 3 or more doses of polio vaccine in the past may get a booster dose of IPV.

Your doctor can give you more information.

If you want to know more about Polio Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Tetanus and diphtheria toxoids (Tdap) Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Tetanus, diphtheria and pertussis can be very serious diseases, even for adolescents and adults. Tdap vaccine can protect us from these diseases.

TETANUS (Lockjaw) causes painful muscle tightening and stiffness, usually all over the body.

  • It can lead to tightening of muscles in the head and neck so you can’t open your mouth, swallow, or sometimes even breathe. Tetanus kills about 1 out of 5 people who are infected.

DIPHTHERIA can cause a thick coating to form in the back of the throat.

  • It can lead to breathing problems, paralysis, heart failure, and death.

PERTUSSIS (Whooping Cough) causes severe coughing spells, which can cause difficulty breathing, vomiting and disturbed sleep.

  • It can also lead to weight loss, incontinence, and rib fractures. Up to 2 in 100 adolescents and 5 in 100 adults with pertussis are hospitalized or have complications, which could include pneumonia or death.

These diseases are caused by bacteria. Diphtheria and pertussis are spread from person to person through coughing or sneezing. Tetanus enters the body through cuts, scratches, or wounds.

Before vaccines, the United States saw as many as 200,000 cases a year of diphtheria and pertussis, and hundreds of cases of tetanus. Since vaccination began, tetanus and diphtheria have dropped by about 99% and pertussis by about 80%.

Tdap vaccine

Tdap vaccine can protect adolescents and adults from tetanus, diphtheria, and pertussis. One dose of Tdap is routinely given at age 11 or 12. People who did not get Tdap at that age should get it as soon as possible.

Tdap is especially important for health care professionals and anyone having close contact with a baby younger than 12 months.

Pregnant women should get a dose of Tdap during every pregnancy, to protect the newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis.

A similar vaccine, called Td, protects from tetanus and diphtheria, but not pertussis. A Td booster should be given every 10 years. Tdap may be given as one of these boosters if you have not already gotten a dose. Tdap may also be given after a severe cut or burn to prevent tetanus infection.

Your doctor can give you more information. Tdap may safely be given at the same time as other vaccines.

If you want to know more about Tetanus and diphtheria toxoids (Tdap) Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Influenza Vaccine Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Influenza (“flu”) is a contagious disease that spreads around the United States every winter, usually between October and May.
Flu is caused by influenza viruses, and is spread mainly by coughing, sneezing, and close contact.

Anyone can get flu, but the risk of getting flu is highest among children. Symptoms come on suddenly and may last several days. They can include:

  • fever/chills
  • sore throat
  • muscle aches
  • fatigue
  • cough
  • headache
  • runny or stuffy nose

Flu can make some people much sicker than others. These people include young children, people 65 and older, pregnant women, and people with certain health conditions—such as heart, lung or kidney disease, nervous system disorders, or a weakened immune system. Flu vaccination is especially important for these people, and anyone in close contact with them.

Flu can also lead to pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children.

Each year thousands of people in the United States die from flu, and many more are hospitalized.

Flu vaccine is the best protection against flu and its complications. Flu vaccine also helps prevent spreading flu from person to person.

Inactivated and recombinant flu vaccines

You are getting an injectable flu vaccine, which is either an “inactivated” or “recombinant” vaccine. These vaccines do not contain any live influenza virus. They are given by injection with a needle, and often called the “flu shot.”

A different, live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement.

Flu vaccination is recommended every year. Some children 6 months through 8 years of age might need two doses during one year.

Flu viruses are always changing. Each year’s flu vaccine is made to protect against 3 or 4 viruses that are likely to cause disease that year. Flu vaccine cannot prevent all cases of flu, but it is the best defense against the disease. It takes about 2 weeks for protection to develop after the vaccination, and protection lasts several months to a year

Some illnesses that are not caused by influenza virus are often mistaken for flu. Flu vaccine will not prevent these illnesses. It can only prevent influenza.

Some inactivated flu vaccine contains a very small amount of a mercury-based preservative called thimerosal. Studies have shown that thimerosal in vaccines is not harmful, but flu vaccines that do not contain a preservative are available.

If you want to know more about Influenza Vaccine Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Hepatitis A Click here for further Vaccine Information Statement (VIS).

Hepatitis A is a serious liver disease caused by the hepatitis A virus (HAV). HAV is found in the stool of people with hepatitis A.

It is usually spread by close personal contact and sometimes by eating food or drinking water containing HAV. A person who has hepatitis A can easily pass the disease to others within the same household.

Hepatitis A can cause:

  • “flu-like” illness
  • jaundice (yellow skin or eyes, dark urine)
  • severe stomach pains and diarrhea (children)

People with hepatitis A often have to be hospitalized (up to about 1 person in 5).

Adults with hepatitis A are often too ill to work for up to a month.

Sometimes, people die as a result of hepatitis A (about 3–6 deaths per 1,000 cases).

Hepatitis A vaccine can prevent hepatitis A.

Who should get hepatitis A vaccine and when?

WHO: Some people should be routinely vaccinated with hepatitis A vaccine:

  • All children between their first and second birthdays (12 through 23 months of age).
  • Anyone 1 year of age and older traveling to or working in countries with high or intermediate prevalence of hepatitis A, such as those located in Central or South America, Mexico, Asia (except Japan), Africa, and eastern Europe. For more information see www.cdc.gov/travel.
  • Children and adolescents 2 through 18 years of age who live in states or communities where routine vaccination has been implemented because of high disease incidence.
  • Men who have sex with men.
  • People who use street drugs.
  • People with chronic liver disease.
  • People who are treated with clotting factor concentrates.
  • People who work with HAV-infected primates or who work with HAV in research laboratories.
  • Members of households planning to adopt a child, or care for a newly arriving adopted child, from a country where hepatitis A is common.

Other people might get hepatitis A vaccine in certain situations (ask your doctor for more details):

  • Unvaccinated children or adolescents in communities where outbreaks of hepatitis A are occurring.
  • Unvaccinated people who have been exposed to hepatitis A virus.
  • Anyone 1 year of age or older who wants protection from hepatitis A.

Hepatitis A vaccine is not licensed for children younger than 1 year of age.

WHEN

For children, the first dose should be given at 12 through 23 months of age. Children who are not vaccinated by 2 years of age can be vaccinated at later visits.

For others at risk, the hepatitis A vaccine series may be started whenever a person wishes to be protected or is at risk of infection.

For travelers, it is best to start the vaccine series at least one month before traveling. (Some protection may still result if the vaccine is given on or closer to the travel date.)

Some people who cannot get the vaccine before traveling, or for whom the vaccine might not be effective, can get a shot called immune globulin (IG). IG gives immediate, temporary protection.

Two doses of the vaccine are needed for lasting protection. These doses should be given at least 6 months apart.

Hepatitis A vaccine may be given at the same time as other vaccines.

If you want to know more about Hepatitis A Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Hepatitis B Click here for further Vaccine Information Statement (VIS).

Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus.

  • In 2009, about 38,000 people became infected with hepatitis B.
  • Each year about 2,000 to 4,000 people die in the United States from cirrhosis or liver cancer caused by hepatitis B.

Hepatitis B can cause:

Acute (short-term) illness. This can lead to:

  • loss of appet
  • tiredn
  • pain in muscles, joints, and stomach
  • diarrhea and vomiting
  • jaundice (yellow skin or eyes)

Acute illness, with symptoms, is more common among adults. Children who become infected usually do not have symptoms.

Chronic (long-term) infection. Some people go on to develop chronic hepatitis B infection. Most of them do not have symptoms, but the infection is still very serious, and can lead to:

  • liver damage (cirrhosis)
  • liver cancer
  • death

Chronic infection is more common among infants and children than among adults. People who are chronically infected can spread hepatitis B virus to others, even if they don’t look or feel sick. Up to 1.4 million people in the United States may have chronic hepatitis B infection.

Hepatitis B virus is easily spread through contact with the blood or other body fluids of an infected person. People can also be infected from contact with a contaminated object, where the virus can live for up to 7 days.

  • A baby whose mother is infected can be infected at birth;
  • Children, adolescents, and adults can become infected by:
    • contact with blood and body fluids through breaks in the skin such as bites, cuts, or sores;
    • contact with objects that have blood or body fluids on them such as toothbrushes, razors, or monitoring and treatment devices for diabetes;
    • having unprotected sex with an infected person;
    • sharing needles when injecting drugs;
    • being stuck with a used needle.
    • household contacts of people infected with hepatitis B,
    • residents and staff in institutions for the developmentally disabled,
    • kidney dialysis patients,
    • people who travel to countries where hepatitis B is common,
    • people with HIV infection.
  • Other people may be encouraged by their doctor to get hepatitis B vaccine; for example, adults 60 and older with diabetes. Anyone else who wants to be protected from hepatitis B infection may get the vaccine.
  • Pregnant women who are at risk for one of the reasons stated above should be vaccinated. Other pregnant women who want protection may be vaccinated.

Adults getting hepatitis B vaccine should get 3 doses—with the second dose given 4 weeks after the first and the third dose 5 months after the second. Your doctor can tell you about other dosing schedules that might be used in certain circumstances.

Hepatitis B vaccine: Why get vaccinated?

Hepatitis B vaccine can prevent hepatitis B, and the serious consequences of hepatitis B infection, including liver cancer and cirrhosis.

Hepatitis B vaccine may be given by itself or in the same shot with other vaccines.

Routine hepatitis B vaccination was recommended for some U.S. adults and children beginning in 1982, and for all children in 1991. Since 1990, new hepatitis B infections among children and adolescents have dropped by more than 95%—and by 75% in other age groups.

Vaccination gives long-term protection from hepatitis B infection, possibly lifelong.

If you want to know more about Hepatitis B Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Chickenpox (varicella) Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Chickenpox (also called varicella) is a common childhood disease. It is usually mild, but it can be serious, especially in young infants and adults.

  • It causes a rash, itching, fever, and tiredness.
  • It can lead to severe skin infection, scars, pneumonia, brain damage, or death.
  • The chickenpox virus can be spread from person to person through the air, or by contact with fluid from chickenpox blisters.
  • A person who has had chickenpox can get a painful rash called shingles years later.
  • Before the vaccine, about 11,000 people were hospitalized for chickenpox each year in the United States.
  • Before the vaccine, about 100 people died each year as a result of chickenpox in the United States.

Chickenpox vaccine can prevent chickenpox.

Most people who get chickenpox vaccine will not get chickenpox. But if someone who has been vaccinated does get chickenpox, it is usually very mild. They will have fewer blisters, are less likely to have a fever, and will recover faster.

Who should get chickenpox vaccine and when?

Routine:- Children who have never had chickenpox should get 2 doses of chickenpox vaccine at these ages:

1st Dose: 12–15 months of age
2nd Dose: 4–6 years of age (may be given earlier, if at least 3 months after the 1st dose)

People 13 years of age and older (who have never had chickenpox or received chickenpox vaccine) should get two doses at least 28 days apart.

Catch-up:- Anyone who is not fully vaccinated, and never had chickenpox, should receive one or two doses of chickenpox vaccine. The timing of these doses depends on the person’s age. Ask your doctor.

Chickenpox vaccine may be given at the same time as other vaccines.

A “combination” vaccine called MMRV, which contains both chickenpox and MMR vaccines, may be given instead of the two individual vaccines to people 12 years of age and younger.

If you want to know more about Chickenpox (varicella) Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Rotavirus Vaccine Click here for further Vaccine Information Statement (VIS).

Why get vaccinated?

Rotavirus is a virus that causes diarrhea, mostly in babies and young children. The diarrhea can be severe, and lead to dehydration. Vomiting and fever are also common in babies with rotavirus.

Before rotavirus vaccine, rotavirus disease was a common and serious health problem for children in the United States. Almost all children in the U.S. had at least one rotavirus infection before their 5th birthday.

Every year:-

  • more than 400,000 young children had to see a doctor for illness caused by rotavirus,
  • more than 200,000 had to go to the emergency room,
  • 55,000 to 70,000 had to be hospitalized, and
  • 20 to 60 died.

Rotavirus vaccine has been used since 2006 in the United States. Because children are protected by the vaccine, hospitalizations, and emergency visits for rotavirus have dropped dramatically

Rotavirus vaccine

Two brands of rotavirus vaccine are available. Your baby will get either 2 or 3 doses, depending on which vaccine is used.

Doses of rotavirus vaccine are recommended at these ages:

  • First Dose: 2 months of age
  • Second Dose: 4 months of age
  • Third Dose: 6 months of age (if needed)

Rotavirus vaccine is a liquid that is swallowed, not a shot.

Rotavirus vaccine may safely be given at the same time as other vaccines.

Rotavirus vaccine is very good at preventing diarrhea and vomiting caused by rotavirus. Almost all babies who get rotavirus vaccine will be protected from severe rotavirus diarrhea. And most of these babies will not get rotavirus diarrhea at all. The vaccine will not prevent diarrhea or vomiting caused by other germs.

Another virus called porcine circovirus (or parts of it) can be found in both rotavirus vaccines. This is not a virus that infects people, and there is no known safety risk. For more information, seehttp://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm205547.htm.

If you want to know more about Rotavirus Vaccine Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements

If you want to know more about Meningococcal Vaccines Click here for further Vaccine Information Statement (VIS).

What is meningococcal disease?

Meningococcal disease is a serious bacterial illness. It is a leading cause of bacterial meningitis in children 2 through 18 years old in the United States. Meningitis is an infection of the covering of the brain and the spinal cord.

Meningococcal disease also causes blood infections.

About 1,000–1,200 people get meningococcal disease each year in the U.S. Even when they are treated with antibiotics, 10–15% of these people die. Of those who live, another 11%–19% lose their arms or legs, have problems with their nervous systems, become deaf, or suffer seizures or strokes.

Anyone can get meningococcal disease. But it is most common in infants less than one year of age and people 16–21 years. Children with certain medical conditions, such as lack of a spleen, have an increased risk of getting meningococcal disease. College freshmen living in dorms are also at increased risk.

Meningococcal infections can be treated with drugs such as penicillin. Still, many people who get the disease die from it, and many others are affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.

What is meningococcal disease?

There are two kinds of meningococcal vaccine in the U.S.:

  • Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 years of age and younger.
  • Meningococcal polysaccharide vaccine (MPSV4) has been available since the 1970s. It is the only meningococcal vaccine licensed for people older than 55.

Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa. There are other types of meningococcal disease; the vaccines do not protect against these.

If you want to know more about Meningococcal Vaccines Click here for further Vaccine Information Statement (VIS).

Go To Vaccination Requirements