In the U.S., the immigration medical exam must be conducted by a physician designated by USCIS (also known as a "civil surgeon"). Print out and bring the most recent version of Form I-693, Report of Medical Examination and Vaccination Record to your medical exam appointment. Complete Part 1 of Form I-693 but do not sign until the doctor instructs you to do so. The civil surgeon will use Form I-693 to document the results of your medical exam and will complete, sign, and seal Form I-693 and any supporting documents in an envelope. IMPORTANT: Do not break the seal or open this envelope.