Instructions For Application For Civil Surgeon Designation (Form I-910) (Page 2 of 10) in pdf

NOTE: Civil surgeon designation is at the discretion of USCIS. Although you may meet the professional qualifications

and other requirements listed on Form I-910, there is no guarantee that USCIS will designate you as a civil surgeon.

What Are the Responsibilities Of A Civil Surgeon?

If USCIS designates you as a civil surgeon, you must comply with the following requirements listed below:

1. You are responsible for truthfully and accurately reporting the results of an applicant’s immigration medical

examination and all laboratory reports on Form I-693 where indicated, and for signing the civil surgeon’s certification

provided on the report.

You must take reasonable steps to ensure that the person appearing for the immigration medical examination is the

same person applying for the requested immigration benefit. All applicants must present a valid government-issued

photo identification (for example, a valid unexpired passport or driver’s license), and you must annotate the form of

identification presented and ID number in Part 1. of Form I-693, if applicable. The law imposes severe penalties

for knowingly and willfully falsifying or concealing a material fact or using any false documents in connection with

immigration medical examinations.

You should also ensure that the applicant’s name and Alien Registration Number (A-Number) (if any) are at the top of

each page of Form I-693 and that they match the information provided in Part 1. of Form I-693.

2. Follow Health and Human Services (HHS) regulations and Centers for Disease Control and Prevention (CDC)

guidelines. USCIS designates civil surgeons with the understanding that you will perform the medical examination

according to HHS’s regulations found at 42 CFR part 34. These regulations include the specific guidelines found

in the Technical Instructions for the Medical Examination of Aliens in the United States (Technical Instructions),

published by the CDC in Atlanta, Georgia. The Technical Instructions (including periodic updates posted by CDC)

are available on the CDC website at

civil-surgeons.html.

3. Make referrals and file case reports, as required. According to the CDC’s Technical Instructions, you are required to:

A. Refer the applicant to the local health department if the chest x-ray suggests tuberculosis (TB) or if other health-

related circumstances are present as described in the CDC’s Technical Instructions;

B. Ensure that testing and therapy are given for diagnoses of communicable diseases of public health significance, as

outlined in the CDC’s Technical Instructions; and

C. File a case report with the appropriate public health authorities if a case report is required by local laws or

regulations. You must also advise the applicant that a case report is being filed.

4. Notify USCIS of any changes relevant to your designation as a civil surgeon. You are responsible for notifying

USCIS in the event that:

A. You cease to practice medicine;

B. You cease to perform immigration medical examinations in the state or at the locations for which you are

designated; or

C. There is a change in your contact information (for example, name of office, address, telephone number, fax

number, or email address).

NOTE: You should notify USCIS within 15 days of the change. See the When and How Do I Update My Civil

Surgeon Information section of these Instructions for more information.

Form I-910 Instructions 12/23/16 N

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Instructions For Application For Civil Surgeon Designation (Form I-910) Page 2