Make an appointment | Bellevue Health Clinic

Immigration Medical Examination

List of Things You Need to Bring:

1. A valid photo ID(PASSPORT/US DRIVER'S LICENSE)

2. Insurance Card

3. I-693 Form

4. vaccine records

5. New patient registration form

Please download and fill out the forms

before your first visit:

Green Card/immigration physical Exam I-693 form.

Instruction for Filling I-693:

Do Not Sign Before you see the doctor. Black ink Only.

For Adults: Fill out Part 1, 2

Under 15 yrs old: Fill out Part 1,2,4

*Make sure there is a bar code on the bottom part of the I-693 Form. And names on top of it on every page.

For Patients who don't understand English,

the Preparer must fill out: Part 1,2,3,4