Minnesota Civil Surgeons
A brief overview of the role of the civil surgeon and a list of USCIS-designated medical providers in Minnesota who can sign off on the I-693 medical exam.
Download PDF version formatted for print:
Minnesota Civil Surgeons (PDF)
Updated 12/2018
On this page:
Understanding the Role of the Civil Surgeon
Validity of the I-693 Form
For Immigrants
For Refugees
Tuberculosis Screening
Vaccinations
More Information
Minnesota Civil Surgeons List
Understanding the Role of the Civil Surgeon and Adjustment of Status for Refugees
Immigrants who have been in the U.S. for one year may complete medical evaluations to adjust their status and obtain a "Green Card" or Legal Permanent Residence status. The medical evaluation requirements are different for refugees and immigrants, so it is important to first determine whether the individual is designated as a refugee or an immigrant. In most cases your patient will know their designation. If they do not know, ask to see their “I-94” card. As a general rule, a refugee will have the word "refugee" printed on their I-94 card. For all applicants, USCIS Form I-693 must be completed, signed, and submitted in a sealed envelope.
The exam needs to be completed by a civil surgeon (a physician officially designated by U.S. Citizenship and Immigration Services or USCIS) or their designee. For applicants with refugee status only, the medical director of local public health in participating counties is also authorized to complete the form.
Validity of the I-693 Form
The applicant must file the I-693 with USCIS within 60 days of signature. The form, then, is valid for a period of up to two years, while the USCIS adjudicates the application. Forms that are submitted after 60 days of signature or completed incorrectly are invalid and the application will be rejected.
Civil surgeons are encouraged to write the signature date on the outside of the envelope of sealed copy of I-693 to facilitate the client or lawyer in correct processing. Consider providing client with an extra (unsealed) copy for their records.
For Immigrants (including asylees and parolees)
- A complete medical examination including immunizations is required.
- The exam must be completed by a civil surgeon (a physician officially designated by USCIS) or their designee.
For Refugees
- For refugees who arrived to the U.S. with a Class A condition (note: this is unusual), the entire medical exam is required, including any necessary vaccinations. In this case, a civil surgeon or their designee must complete the exam.
- For refugees who arrived to the U.S. without a Class A condition, only immunizations need to be reviewed and updated. In this case, a civil surgeon or their designee or the medical director of local public health in participating counties must complete the exam.
- Refugees who only need to submit the vaccination record should submit the entire Form I-693, but only need to complete the following sections:
- Part 1: Information About You
- Part 2: Applicant's Statement, Contact Information, Certification, and Signature
- Part 3: Interpreter Contact Information, Certification, and Signature
- Part 4: Applicant's Identification Information
- Part 6: Civil Surgeon's Contact Information, Certification, and Signature
- Part 9: Vaccination Record
CONSIDERATIONS FROM TECHNICAL INSTRUCTIONS
Tuberculosis Screening
Tuberculosis screening applies to all non-refugee immigrants (and refugees who arrived with a Class A waiver). Per September 2018 Technical Instructions, all applicants 2 years or older MUST have an IGRA TB test (not a TST). Positive IGRAs, applicants with known HIV infection, and those with signs or symptoms of TB disease must have a chest x-ray. Those applicants with a positive IGRA for whom active TB disease is ruled out have latent tuberculosis infection (LTBI). Civil surgeons should report LTBI diagnoses to the Minnesota Department of Health within 30 days of I-693 completion, using the Minnesota Latent TB Infection (LTBI) Reporting Form (PDF). While a release of information is not needed, patients should be informed of this referral.
Vaccinations
All applicants must meet vaccination requirements for the list of diseases designated by the Centers for Disease Prevention and Control for adjustment of status purposes. This is a subset of the Advisory Committee for Immunization Practices (ACIP) guidelines, and ACIP guidance should be followed regarding age, dosage, timing, and contraindications. As completion of a vaccine series often requires several months, the series may not be complete at the time of I-693 completion. Applicants are required to receive from the civil surgeon at least one dose of each age-appropriate vaccine listed in Table 1 for which the applicant is not currently up to date. Applicants should be encouraged to follow up with a primary health care provider to complete the series.
- Free or Low-Cost Shots for Children
Information on how to determine if your child can get free or low-cost immunizations. - Vaccination Clinics Serving Uninsured and Underinsured Adults
Search for clinics with free vaccine for qualifying uninsured and underinsured adults. For adults (19 years and older), immunizations may be available at low-cost at the local public health agency in the county in which they reside or in other participating clinics.
For More Information
- Download the complete Form I-693, Report of Medical Examination and Vaccination Record from the U.S. Citizenship and Immigration Services.
- Find a Doctor who is authorized by the U.S. Citizenship and Immigration Services.
- CDC offers guidance on:
- Additional guidance is available from the MDH Refugee Health Program at 651-201-5414
Minnesota Civil Surgeons List
Administrative fees for completing the I-693 form are not covered by insurance and vary between civil surgeons. Please check with the clinic for details.
Dakota County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
DAKOTA COUNTY PUBLIC HEALTH DEPARTMENT |
Dr. Stiffman |
Dakota County Western Service Center 952-891-7500 |
|
MD PHYSICALS, INC. |
Dr. Partida-Ruesga |
14135 Cedar Ave. #300 952-431-9655 |
|
Hennepin County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
AA PHYSICIANS |
Dr. Axelrod |
6545 France Ave. S 952-846-7446 |
|
AM PHYSICIANS |
Dr. Bacaner Dr. Mirman |
4201 Excelsior Blvd. 952-564-3882 |
|
AMERICAN IMMIGRATIONS OF TWIN CITIES MEDICAL CENTER |
Dr. Green Dr. Oldenburg |
3264 W Lake St. 612-285-9996 |
|
BOYNTON HEALTH SERVICE |
Dr. Park Dr. Risdahl |
410 Church St. SE 612-625-3222 |
|
CENTRAL AVENUE CLINIC- NEIGHBORHOOD HEALTHSOURCE |
Dr. Price-Isuk |
2610 Central Ave NE 612-781-6816 |
|
COMMUNITY-UNIVERSITY HEALTH CARE CENTER (CUHCC) |
Dr. Borowsky Dr. Reif |
2001 Bloomington Ave. 612-301-3433 |
|
CROWN MEDICAL CENTER |
Dr. Nguyen Dr. Onyekaba |
100 E. Franklin Ave. S 1925 First Ave. S 6901 78th Ave. N 612-871-2644 |
|
FREEMONT CLINIC- NEIGHBORHOOD HEALTHSOURCE |
Dr. Vint |
3300 Freemont Ave. N 612-588-9411 |
|
HENNEPIN COUNTY MEDICAL CENTER PEDIATRICS |
Dr. Maroushek |
701 Park Ave. 612-873-6963 |
|
HENNEPIN COUNTY PUBLIC HEALTH CLINIC |
Dr. Tsukayama |
525 Portland Ave. 612-543-5555 |
|
ODAM MEDICAL GROUP |
Dr. Larbi-Odam |
920 East 28th St. 612-871-2312 |
|
SHERIDAN NEIGHBORHOOD HEALTHSOURCE |
Dr. Benzie Dr. Bresette |
342 13th Ave. NE 612-362-4111 |
|
V KARE CLINIC |
Dr. Hussain |
11209 Commerce Drive N 763-323-6564 |
|
Koochiching County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
ESSENTIA HEALTH |
Dr. Helleloid |
2501 Keenan Drive 218-283-9431 |
|
Lyon County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
AFFILIATED COMMUNITY MEDICAL CENTERS-MARSHALL |
Dr. Kremer Dr. Odland |
1521 Carlson St. 507-532-1114 |
|
Olmsted County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
MAYO CLINIC- PREVENTIVE MEDICINE DIVISION |
Dr. Cowl Dr. Hagen Dr. Molella Dr. Swift |
200 First St. 507-284-4340 |
|
OLMSTED COUNTY PUBLIC HEALTH |
Dr. Molella |
2100 Campus Drive SE 507-328-7500 |
|
Ramsey County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
CENTER FOR INTERNATIONAL HEALTH |
Dr. Perelman |
451 N Dunlap St. 952-967-7201 |
|
CENTRAL MEDICAL CLINIC |
Dr. Morales |
393 N Dunlap St. LL34 651-644-6002 |
|
COMPLETE HOME HEALTH SERVICES |
Dr. Nomo-Ongolo |
Silver Lake Plaza Building 612-788-2273 |
|
EZY URGENT CARE |
Dr. Perelman |
1001 Johnson Parkway 651-646-0028 |
|
HEALTHEAST ROSELAWN CLINIC |
Dr. Everson |
1983 Sloan Place 651-326-5700 |
|
WEST SIDE COMMUNITY HEALTH SERVICES |
Dr. Benfield Dr. Nesvig |
153 Cesar Chavez St. 651-222-1816 |
|
Roseau County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
ALTRU HEALTH SYSTEM |
Dr. Anderson |
711 Delmore Drive 218-463-1365 |
|
Stearns County
Agency |
Civil Surgeon |
Address/Phone |
Services Offered |
ODAM MEDICAL GROUP |
Dr. Larbi-Odam |
3405 3rd St. N 320-774-3800 |
|