5276 Dawes Ave, Alexandria, VA 22311     Tel:  571-777-8494    Cell:  703-887-8892   

Dr. Tesfaye Tetemke has USCIS Civil Surgeon Designation to perform Immigration Medical Examination. We follow the  Centers for Disease Control and Prevention (CDC) guidelines, and  U.S. Citizenship and Immigration Services Instructions to complete your Immigration medical examination. The Report of Medical Examination and Vaccination Record (USCIS Form 1-693) is used to report the results of the medical examination.  When you come to your appointment for the immigration medical examination please bring the following: A valid government-issued photo ID (Passport or driver’s license), your Vaccination records, Means of payment ( Cash or credit card, or check),  Other relevant records such as TB treatment and chest x-ray reports, if available.

 During your visit, the Civil Surgeon will explain to you about the Immigration Medical Examination, required Immunizations, and lab tests.  The required lab tests are blood tests for tuberculosis (TB) and syphilis, and urine tests for gonorrhea. In addition, the Civil Surgeon will do the following:

      •  Verify your identity by requiring a valid Government-issued ID
      •  Perform initial Medical exam including history and physical exam
      •  Review of your Vaccination and other relevant records
      •  Administer or order required vaccinations
      •  Draw or Order blood tests for syphilis (RPR) and tuberculosis (TB).
      •  Collect or Order urine Test for Gonorrhea (Urine NAAT for GC)
      •  Schedule a chest X-Ray, only If required
      •  Ask You to sign the Applicant’s Certification Part of Form I-693.
      •  Provide you the completed Form I-693 for USCIS use and a copy for your records.

 Signature of the Applicant: 

  • If you are 14 years of age or older you (the applicant) must sign Form I-693. However, a legal guardian may sign for a mentally incompetent person. 
  • If you are under 14 years of age, your parent or legal guardian may sign the form on your behalf. A legal guardian may also sign for a mentally incompetent person.

Form I-693 (PDF, 651.05 KB)

 Instructions for Form I-693 (PDF, 514.99 KB)

Technical Instructions for Medical Examinations of Aliens