How to Fill Out USCIS Form I-910 (w/Examples) + FAQs

You fill out USCIS Form I-910, the Application for Civil Surgeon Designation, by completing six parts that confirm your identity, your medical license, your board certification or four years of clinical experience, and your office address, then mailing the signed form with the $990 filing fee and supporting evidence to the USCIS lockbox listed on the current form instructions. The form turns a licensed M.D. or D.O. into a USCIS-designated civil surgeon who can perform the immigration medical exam on Form I-693 for green card applicants inside the United States.

The wrong answer on a single line, a missing license copy, or an outdated fee can trigger a Request for Evidence or a flat denial under 8 CFR 232.2. According to USCIS, more than 9 million Form I-693 medical exams have been processed by designated civil surgeons over the last decade, which is why the agency screens every I-910 with care.

🩺 The exact line-by-line walkthrough of each I-910 field, with no skipped boxes
📑 The license, board, and experience proofs USCIS demands and why each one matters
💵 The current fee, mailing address, and filing checklist that prevents lockbox rejection
⚖️ The federal rules under INA §232 and 8 CFR 232.2 that drive every decision
🛑 The most common mistakes, blanket-designation rules, revocation traps, and state-by-state license nuances

What Form I-910 Is and Why It Exists

Form I-910 is the federal application a physician files to become a civil surgeon, which is the only category of doctor USCIS allows to sign the immigration medical exam Form I-693 inside the United States. The legal authority comes from INA §232(a), which orders medical screening of intending immigrants, and from 8 CFR 232.2, which tells USCIS how to pick the doctors who run those exams. Without this designation, even a board-certified surgeon at the Mayo Clinic cannot legally complete the I-693 for an adjustment of status applicant.

The plain-English idea is that the federal government wants a vetted pool of doctors who follow the CDC Technical Instructions for Civil Surgeons. The consequence of skipping the I-910 and signing an I-693 anyway is that USCIS will reject the medical exam, the green card application can be delayed by months, and the doctor can face referral to the state medical board for unauthorized practice in a federal program. A common misconception is that any U.S. licensed doctor may sign an I-693, but only a designated civil surgeon, a panel physician working abroad, or a military physician under the blanket rule may do so.

A real-world example helps. Dr. Maya Chen runs a family clinic in San Diego and wants to add immigration medicals to her practice; until USCIS approves her I-910, every I-693 she signs is void. Once she is designated, she appears in the Find a Doctor tool on the USCIS website and can charge market rates for the exam. The designation is tied to a specific street address, so if Dr. Chen later opens a second clinic in Oceanside she must file a new I-910 for that office.

Who Qualifies as a Civil Surgeon

A civil surgeon must be a licensed medical doctor (M.D.) or doctor of osteopathic medicine (D.O.) with an active, unrestricted license in the U.S. state or territory where the office is located. The applicant must also have at least four years of professional experience after receiving the medical degree, or hold a current specialty board certification in any field recognized by the American Board of Medical Specialties or the American Osteopathic Association. Foreign medical graduates qualify if they meet U.S. licensing and experience rules, and the four-year clock starts the day the medical degree is granted, not the day residency ends.

The consequence of misreading the experience rule is denial without refund of the $990 fee. A common misconception is that a residency does not count toward the four years, but USCIS does count post-degree residency and fellowship time. Dr. Anil Rao, who graduated medical school in 2021, became board-certified in internal medicine in 2024, and applied in 2026, qualifies through board certification even though he is short of the four-year mark.

How the Designation Connects to Form I-693

Form I-693 is the medical exam form that adjustment-of-status applicants submit to USCIS, usually with their Form I-485. Only a designated civil surgeon may sign Section 7 of the I-693 inside the United States, and the signature must match the address on the approved I-910. If a civil surgeon signs from a different clinic than the one on file, USCIS treats the I-693 as defective and may issue a Request for Evidence under the USCIS Policy Manual Volume 8.

The consequence of using a non-designated doctor is a wasted exam, a wasted lab draw, and another vaccination round, which can cost the applicant $400 to $700 out of pocket. A common misconception is that telehealth visits count, but the I-693 exam must occur in person at the designated office. Sofia Alvarez, a green card applicant in Phoenix, learned this the hard way when her primary care doctor signed her I-693 without being designated, forcing her to redo the exam with a civil surgeon.

The 2026 Filing Fee, Address, and Form Edition

The current filing fee for Form I-910 is $990, set by the USCIS fee rule effective April 1, 2024. USCIS does not waive this fee, and there is no reduced fee for solo practitioners or non-profit clinics. Pay by personal check, cashier’s check, money order, or Form G-1450 for credit card payment, made out to “U.S. Department of Homeland Security.”

You must use the latest edition of the form posted on the USCIS I-910 page; older editions are rejected at the lockbox. As of May 2026, USCIS routes all I-910 filings to the Phoenix Lockbox at the address printed in the current form instructions, and you can verify the address before mailing through the direct filing addresses page. The consequence of mailing to the wrong address is a returned package and a delay of two to four weeks.

A common misconception is that the fee is per physician group, but each doctor pays the full $990, even if five doctors share one office. Dr. Lillian Park, who joined a four-doctor clinic in Brooklyn in March 2026, had to file her own I-910 with her own check, even though her partners were already designated.

Step-by-Step Walkthrough of Form I-910

The form has six parts plus a signature block. Read every line of the form instructions before you write anything, because USCIS uses optical character recognition and rejects forms with stray marks, white-out, or pen colors other than black.

Part 1: Information About You

This part asks for your full legal name, any other names used, your date of birth, your country of birth, your country of citizenship, and your USCIS Online Account Number if you have one. Use your name exactly as it appears on your state medical license, because mismatches cause Requests for Evidence. If you are a foreign medical graduate who naturalized, list your prior name in the “other names used” field.

The consequence of dropping a middle name or using a nickname is a delay while USCIS confirms your identity against the state medical board. A common misconception is that you can write “same as license,” but every box must be filled in. Dr. Daniel O’Connor-Smith must spell out the hyphenated last name even though it is long, and he must include “Daniel Patrick O’Connor” if that is the name on his medical school diploma.

Part 2: Information About Your Medical Practice

Here you list the practice name, the street address, the suite number, the city, the state, the ZIP code, and the phone number where you will perform the immigration medical exam. The address must be a physical office, not a P.O. box, because USCIS sends applicants to that exact location through the Find a Doctor tool. If you practice at more than one address, you must file a separate I-910 with a separate $990 fee for each address.

The consequence of listing a P.O. box is automatic rejection. A common misconception is that a hospital affiliation is enough, but the address must be where the exam actually happens. Dr. Maya Chen lists 1234 Adams Avenue, Suite 200, San Diego, CA 92116, and adds her direct office line, not the hospital switchboard.

Part 3: Eligibility Information

Part 3 asks you to check the box that matches your eligibility basis: either four years of professional experience after the medical degree, or current board certification. You also list your medical school, the date your degree was awarded, your residency training, your specialty, and the date your board certification was issued and expires. Civil surgeons must keep that information truthful and current under penalty of revocation.

The consequence of checking both boxes when only one applies is an RFE asking for clarification. A common misconception is that an expired board certification still counts, but USCIS requires a current certification on the filing date. Dr. Anil Rao checks the board-certification box and writes “American Board of Internal Medicine, certified May 12, 2024, valid through December 31, 2034.”

Part 4: License Information

List the state that issued your license, the license number, the issue date, and the expiration date. Attach a clear photocopy of the license itself, and if your state issues a wallet card and a wall certificate, send copies of both. The license must be unrestricted, which means no probation, no supervised practice condition, and no limitation to a specific facility.

The consequence of a restricted license is denial under 8 CFR 232.2(b). A common misconception is that a “training license” or a “house-staff permit” qualifies, but those are restricted and do not. Dr. Lillian Park, licensed in New York, attaches her New York State Department of Health license printout showing “Registration Status: Registered” and an expiration date in 2027.

Part 5: Contact Information, Declaration, Certification, and Signature

You sign and date the form in black ink, list your daytime phone number, your mobile number, and your email address. The signature certifies under penalty of perjury that every answer is true, that you will follow the CDC Technical Instructions, and that you will report any change in license status within 30 days. A typed signature, an electronic signature, or a signature stamp is not accepted; USCIS rejects the form at the lockbox.

The consequence of a missing or stamped signature is automatic rejection. A common misconception is that an attorney can sign for the doctor, but only the applicant physician may sign Part 5. Dr. Daniel O’Connor-Smith signs in blue-black ink, dates the form 05/10/2026, and double-checks the email he uses every day so USCIS notices reach him quickly.

Part 6: Interpreter and Preparer (If Used)

If someone helped you prepare the form, that person completes Part 6 with their name, business, address, and signature. Most physicians do not use a preparer, but immigration attorneys often do, and the attorney must also file Form G-28 to appear on the record. Leaving Part 6 blank is fine if you prepared the form yourself.

The consequence of an attorney filling in Part 6 without filing G-28 is that USCIS will not communicate with the attorney. A common misconception is that a paralegal signature is enough, but the actual preparer must sign. Sofia Alvarez’s attorney, who helps two civil surgeons each year, signs Part 6 and files a G-28 to receive every notice.

Three Real-World Filing Scenarios

The table below shows how three different physicians complete the form and what happens at each step.

Filing Choice	USCIS Outcome
Dr. Maya Chen files I-910 with board certification, $990 fee, and one San Diego address	Designation approved in 4 months and address listed on Find a Doctor tool
Dr. Anil Rao files I-910 listing a P.O. box and a residency-training license	Lockbox rejection for P.O. box and denial for restricted license, fee refunded
Dr. Lillian Park files I-910 with active New York license and three years of experience	RFE issued for missing fourth year; she answers with board certification proof and is approved

A second table compares the two eligibility paths.

Eligibility Path	Practical Effect
Four years of post-degree professional experience	Useful for older physicians without current board certification, but requires CV and employer letters
Current ABMS or AOA board certification	Faster to prove with a single certificate, but the certification must be unexpired on the filing date

A third table compares the civil surgeon designation to the panel physician role abroad.

Doctor Type	Where the Exam Happens
Civil surgeon designated through Form I-910	Inside the United States for adjustment-of-status applicants on Form I-693
Panel physician approved by the U.S. Department of State	Outside the United States for consular immigrant visa applicants on Form DS-2054

Documents You Must Mail With the Form

USCIS requires the I-910, the fee, and a tight evidence packet. The current form instructions list the items, and missing any one of them triggers an RFE that adds two to four months to processing.

A clear copy of your unrestricted state medical license, front and back
A copy of your current board certification, if you rely on board certification for eligibility
A signed CV or résumé showing four years of post-degree experience, if you rely on experience
A copy of your medical school diploma or, for foreign graduates, an ECFMG certificate
Letters from past employers confirming dates and roles, if you use the experience path
A check, money order, or Form G-1450 for the $990 fee, payable to “U.S. Department of Homeland Security”

The consequence of missing the diploma copy is an RFE even if your license is on file, because USCIS audits the medical-degree date against your experience claim. A common misconception is that a National Provider Identifier printout substitutes for the license, but it does not. Dr. Maya Chen mails a 22-page packet, organized with tab dividers, so the officer can find each exhibit fast.

Federal Law and Regulations Behind the Form

The statutory base is INA §232, codified at 8 USC §1222, which lets the federal government screen intending immigrants for medical conditions of public health concern. The regulation at 8 CFR 232.2 lists the eligibility rules for civil surgeons, including the four-year experience requirement, the unrestricted license rule, and the revocation grounds. The USCIS Policy Manual Volume 8, Part C walks through every adjudication standard the officers use.

The consequence of a regulation update mid-application is that USCIS applies the rule in effect on the filing date, not the decision date. A common misconception is that state medical board rules override federal rules, but federal rules control civil surgeon designation. Dr. Daniel O’Connor-Smith keeps a printed copy of the policy manual section in his office binder so that staff can answer applicant questions about the I-693 vaccination chart.

CDC Technical Instructions

Every civil surgeon must follow the CDC Technical Instructions for Civil Surgeons when performing the exam. The instructions cover tuberculosis screening, syphilis and gonorrhea testing for applicants 18 to 24 years old, and the vaccination chart that must be completed for every I-693. The CDC updates the instructions when public health guidance changes, such as the 2021 addition of COVID-19 vaccination, which was later removed in 2025.

The consequence of skipping a required test is that USCIS rejects the I-693 and the applicant must redo the exam. A common misconception is that a flu shot satisfies the influenza requirement year-round, but the requirement only applies during the listed flu season. Sofia Alvarez’s civil surgeon checked the CDC website the morning of her exam and confirmed that the COVID-19 row was no longer required.

Blanket Designation for Military Physicians

Active-duty military physicians and civilian doctors employed by the U.S. armed forces have a blanket designation under USCIS guidance for armed forces medical officers, which means they do not file Form I-910 to serve military beneficiaries on a base. They still file I-910 if they want to perform civilian I-693 exams off-base. The blanket rule keeps the immigration medical pipeline open for service members and their families.

The consequence of confusing blanket designation with civilian designation is that a retired military doctor may sign I-693s in private practice without authority. A common misconception is that VA physicians have blanket designation, but they do not. Dr. Anil Rao, a Navy reservist, can sign I-693s on base under the blanket rule, but he files I-910 for his weekend civilian clinic.

Mistakes to Avoid

These mistakes cost applicants time and money, and several lead to outright denial.

Mailing the form to the wrong USCIS lockbox address, which causes return mail and a four-week delay
Using an outdated edition of Form I-910, which triggers automatic rejection at intake
Listing a P.O. box instead of a physical office, which violates 8 CFR 232.2 and produces a denial
Submitting a residency training license or a probation-restricted license, which fails the unrestricted-license rule
Forgetting the medical school diploma exhibit, which generates an RFE even when the state license is attached
Sending an unsigned form or a stamped signature, which is rejected at the lockbox without review
Paying the wrong fee amount, such as the prior $785 figure, which now requires a top-up check and adds weeks
Skipping Form G-28 when an attorney prepares the application, which cuts the attorney out of all USCIS notices
Failing to update the address within 30 days of a move, which is a revocation ground under 8 CFR 232.2(d)
Listing two practice addresses on one I-910, when each address requires its own form and its own fee

Do’s and Don’ts

The list below pairs each rule with its underlying reason so you can apply judgment in edge cases.

Do file the latest edition of Form I-910, because USCIS rejects superseded editions at intake
Do attach both license proofs if your state issues two, because the officer wants belt-and-suspenders evidence
Do keep a complete copy of the package, because USCIS does not return originals and you may need to re-file
Do write your full legal name on the check memo line, because lockbox cashiers match the check to the form
Do read the Form I-693 instructions before designation, because you will sign that form once approved
Don’t use white-out or correction tape, because OCR scanners flag corrected fields and slow processing
Don’t sign in pencil or with a stamp, because the signature must be a wet ink original
Don’t pay with a starter check or a temporary check, because lockbox banks reject those
Don’t list a virtual office, because USCIS verifies the address against state medical board records
Don’t ignore an RFE deadline, because a missed deadline equals a denial under 8 CFR 103.2(b)(13)

Pros and Cons of Becoming a Civil Surgeon

Designation creates a steady revenue stream but also adds compliance work.

Pro: Adds a paid service line, since civil surgeons charge $200 to $500 per I-693 exam in most cities
Pro: Brings your office into the USCIS Find a Doctor tool, which generates inbound referrals at no cost
Pro: Builds rapport with immigrant patients, who often become long-term primary care patients
Pro: Supports community health, because timely vaccinations and TB screens benefit the broader public
Pro: Keeps your federal credentials current, which can help if you later seek panel physician status abroad
Con: Adds CDC compliance work, because the Technical Instructions change often and require staff training
Con: Increases malpractice exposure, since a missed TB diagnosis can trigger both a tort claim and a federal complaint
Con: Requires accurate vaccine inventory and cold chain logs, which add overhead for small clinics
Con: Locks the designation to one address, which means another $990 fee for every additional location
Con: Subjects you to revocation under 8 CFR 232.2(d) for license issues, fraud findings, or address mismatches

State-by-State Nuances

Federal rules control I-910 designation, but state license rules feed into the eligibility analysis. The state medical board determines whether your license is “unrestricted,” and USCIS defers to that record. Below are four high-volume states where physicians often run into state-specific issues.

California

The Medical Board of California lists license status as “Current” or “Delinquent,” and only “Current” counts as unrestricted for I-910 purposes. California also requires a separate fictitious name permit if the practice operates under a name different from the physician’s, and USCIS will compare the I-910 practice name to that permit. The state’s Continuing Medical Education rule, 50 hours every two years, must stay satisfied or the license can lapse and the I-910 designation can be revoked.

The consequence of letting CME slip is a board citation, which can flip the license to a restricted status and trigger USCIS revocation. A common misconception is that CME extensions buy time with USCIS, but USCIS treats any restriction as disqualifying. Dr. Maya Chen uses an automated CME tracker so her California license stays clean during the I-910 review.

Texas

The Texas Medical Board issues licenses and posts disciplinary orders publicly, so an applicant with any pending order should expect an RFE. Texas also has a strong telemedicine framework, but a civil surgeon may not perform the I-693 over telehealth, so the Texas telemedicine rules do not help here. Border-region physicians in El Paso and Brownsville often see large I-693 volume because of the proximity to consular processing for family members.

The consequence of an open Texas board investigation is an RFE while USCIS waits for a final order. A common misconception is that an “Agreed Order” with no probation is unrestricted, but USCIS still reviews the order language. Dr. Anil Rao, practicing in Houston, attaches a copy of the Texas license verification page from the board’s online tool so the officer does not have to look it up.

Florida

The Florida Department of Health verifies licenses online, and Florida has a high concentration of foreign medical graduates who often qualify through board certification rather than experience. Florida physicians who hold an Institutional Practice License (IPL) cannot use that license for I-910, because IPL is restricted to a specific institution. Miami-Dade and Broward counties produce a large share of Florida I-693 filings due to local immigrant populations.

The consequence of relying on an IPL is denial. A common misconception is that the IPL converts to a full license once the physician completes residency, but the physician must apply for the full Florida M.D. or D.O. license separately. Sofia Alvarez’s civil surgeon in Hialeah holds the full Florida M.D. license, not an IPL, which is why his I-910 cleared without issue.

New York

The New York State Education Department Office of the Professions handles physician licenses, and the New York State Department of Health handles practice issues. New York requires a triennial registration, and an unregistered license counts as inactive for I-910 purposes. New York City civil surgeons often work in multi-language clinics, which is helpful for the I-693 because the form must be completed in English regardless of the patient’s primary language.

The consequence of an unregistered New York license is a denial that USCIS can cure only after the physician registers and re-files. A common misconception is that a New York “limited permit” qualifies, but it does not because it is restricted to specific supervised settings. Dr. Lillian Park, practicing in Brooklyn, registered her license a month before filing so the registration end date safely covers the entire I-910 review.

Processing Time, Decisions, and Revocation

USCIS does not publish a separate processing-time chart for I-910, but most cases close in three to six months once the lockbox accepts the filing. You can check status on the USCIS Case Status tool using the receipt number on Form I-797. If approved, you receive a designation notice listing your civil surgeon ID, your office address, and the effective date.

The agency may revoke a designation at any time under 8 CFR 232.2(d) for license suspension, criminal conviction, fraud, or repeated I-693 errors. Revocation can be temporary or permanent, and the physician has no formal appeal right but may file a motion to reopen under 8 CFR 103.5. A common misconception is that designation lasts forever; in practice, USCIS treats it as ongoing only while every eligibility factor stays true.

A real-world example is the 2023 Matter of a designated civil surgeon AAO non-precedent decision, in which a physician’s designation was revoked after the state medical board placed the doctor on probation, and the AAO sustained the revocation because probation is a license restriction under 8 CFR 232.2(b). Dr. Daniel O’Connor-Smith therefore reports any board action to USCIS within 30 days through the address-and-status update process listed in the USCIS Policy Manual.

After Approval: Running Immigration Medical Exams

Once approved, you order vaccine stock that matches the CDC vaccination chart, set up TB testing through a CLIA-waived lab, and price the exam fairly for your community. USCIS expects you to keep records for at least three years and to provide them on request, which the agency does during periodic compliance audits. You also sign each I-693 in a sealed envelope so the applicant can submit it intact to USCIS.

The consequence of poor record-keeping is a compliance audit finding that can lead to revocation. A common misconception is that emailing a scanned I-693 to the applicant is fine, but USCIS requires the sealed envelope rule for chain of custody. Dr. Maya Chen keeps a digital archive plus a paper copy and labels each envelope with the applicant’s A-Number so the file matches the I-485 record.

FAQs

Is Form I-910 the only way to become a civil surgeon?

Yes. Civilian physicians must file Form I-910 to be designated, although active-duty and federal armed-forces medical officers serving military beneficiaries on base operate under the separate blanket designation rule.

Do I have to pay the $990 fee for each office address?

Yes. USCIS ties each designation to one physical address, so a physician with three office locations files three separate Form I-910 packages and pays $990 for each.

Can a nurse practitioner or physician assistant become a civil surgeon?

No. Only a licensed M.D. or D.O. with an unrestricted state license and either four years of post-degree experience or current board certification qualifies under 8 CFR 232.2.

Will a residency training license satisfy the license requirement?

No. A residency or training license is restricted to a teaching hospital and does not meet the unrestricted-license rule, so USCIS will deny the I-910 if that is the only license attached.

Is a current board certification always faster than the four-year experience path?

Yes. A single certification page proves eligibility cleanly, while the experience path usually requires a CV and several employer letters, which take longer to gather and review.

Can I sign an I-693 by telehealth once I am designated?

No. USCIS and the CDC require an in-person physical exam at the address listed on your approved Form I-910, so a telehealth visit will not produce a valid I-693.

Does USCIS refund the fee if my application is denied?

No. The $990 fee is a filing fee, not a designation fee, so USCIS keeps it whether the case is approved or denied; only a lockbox rejection produces a returned check.

Will a pending state medical board complaint stop my I-910?

Yes. USCIS often issues a Request for Evidence and can deny if the complaint results in restriction, probation, or suspension before the agency makes a decision.

Do I need to file Form G-28 if my attorney helps me?

Yes. Form G-28 places the attorney on the record so USCIS can send notices and respond to inquiries, and the same attorney must also complete Part 6 of Form I-910.

Can my civil surgeon designation be revoked?

Yes. USCIS may revoke at any time for license issues, criminal findings, fraud, or repeated I-693 errors under 8 CFR 232.2(d), and there is no direct appeal but a motion to reopen is possible.

Is the COVID-19 vaccination still required for the I-693 in 2026?

No. The CDC removed the COVID-19 row from the vaccination requirements in 2025, although other vaccines such as MMR, Tdap, and seasonal influenza remain required when in season.

Will USCIS list me publicly once approved?

Yes. Approved civil surgeons appear in the public Find a Doctor tool with the office address and phone number, which sends inbound applicant referrals at no marketing cost.

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