
U. S. Department of State OMB No. 14050113 EXPIRATION DATE: XX/XX/XXX ESTIMATED BURDEN: 10 minutes (See Page 2 Back of Form)REPORT OF MEDICAL EXAMINATION BY PANEL PHYSICIAN PhotoSurnamesGiven NamesBirth.
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How to fill out the DOS DS-2054 online
The DOS DS-2054 is a vital document used to report medical examination results for visa applicants. This guide provides a clear, step-by-step approach to completing the form online, ensuring that users can navigate each section with confidence.
Follow the steps to easily complete the DOS DS-2054 online.
- Click the ‘Get Form’ button to access the DOS DS-2054 and open it in your preferred online editor.
- Provide your surnames and given names accurately as they appear on official documents. Ensure the spelling is correct for identity verification purposes.
- Enter your birth date in the mm-dd-yyyy format. This is important for age verification and eligibility assessments.
- Select your sex by marking 'M' for male or 'F' for female. This information is typically used for identification.
- Fill in the U.S. Consulate or Embassy you are applying to. This is crucial for the processing of your visa application.
- Input the document type and corresponding document number that relates to your application.
- Provide your case or alien number if applicable. This number assists in tracking your application.
- Fill out your birthplace details, including city and country of birth for proper identification.
- Indicate your present country of residence and prior country of residence, if relevant.
- Complete your current and intended U.S. address, including city, state, and postal code.
- Enter your phone number and email address to facilitate communication regarding your application.
- Specify your country of nationality for accurate documentation of your identity.
- Record the date of your medical exam in mm-dd-yyyy format, marking either the examination date or the date of final TB culture results.
- Indicate the date on which the exam expires. This is typically three months or six months based on your TB classification.
- Complete information relating to the exam, including the date and place of the current exam, and prior exams, if any.
- Document all laboratory information as applicable, including the radiology facility and associated tests.
- Choose the applicant category that applies to you, making sure to check all relevant boxes.
- Sign and date the form as the panel physician performing the examination, verifying that all information is accurate.
- Once you have filled out all sections, review the form for accuracy and completeness before submitting.
- Finally, save your changes, download a copy, print the form, or share it as necessary.
Start filling out your DOS DS-2054 online today to ensure your medical examination is reported accurately!
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Get answers to your most pressing questions about US Legal Forms API.
Can I use my insurance for USCIS medical exam?
Health insurance does not cover the cost for the I-693 medical exam for your Green Card application. To reduce the costs have your vaccines updated and your medical record to show the Civil Surgeon who will complete the USCIS I-693 form.
How long is DS 2054 valid for?
Medical Examination Validity PeriodsLength of Validity for All Components of the Medical ExamMedical Examination date that should be listed on Form DS-2054 or 77946 months1Physical examination date3 months2Date final TB culture results reported by lab
Who pays for medical exam for green card?
Yes, an applicant is responsible for paying all doctor and laboratory fees for the medical examination. The fee for a green card medical exam varies by doctor.
What is Form DS 2054?
A. Panel physicians must annotate the results of the immigration medical examination on the Electronic Medical Examination for Visa or Refugee Applicant (Form DS-7794) or the Medical Examination for Visa or Refugee Applicant (Form DS-2054), and related worksheets.
How much does the USCIS medical exam cost?
The USCIS medical exam costs between $100—$500, depending on your state, region, and civil surgeon. The USCIS does not have any regulations about how much a medical exam for immigration should cost since it's at the discretion of your physician.
What does USCIS medical exam cover?
Immigration physicals may include blood tests (a complete blood count) and chest x-rays. For individuals aged 15 and up, you will need a blood test to check for syphilis and a urine test to check for gonorrhea.
Is USCIS medical exam covered by insurance?
Otherwise you will have to pay out of pocket to the Civil Surgeon for any additional labs/immunizations that are needed to complete the exam. The exam itself along with the paperwork for immigration is not covered by insurance.
When should I take my medical exam for I-485?
We still encourage you to undergo the immigration medical examination close to the time you file your Form I-485, because your Form I-693 is only valid for 2 years from the date of the civil surgeon's signature. After the 2-year time frame, you must submit a new Form I-693 if we have not adjudicated your Form I-485.
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