Instructions For Application For Civil Surgeon Designation (Form I-910) printable pdf download

Instructions forApplication for Civil Surgeon Designation

USCIS

Form I-910

Department of Homeland Security

OMB No. 1615-0114

U.S. Citizenship and Immigration Services

Expires 05/31/2018

What Is the Purpose of Form I-910?

Form I-910, Application for Civil Surgeon Designation, is to be used by physicians seeking designation as a civil surgeon.

What Is A Civil Surgeon?

By law, a civil surgeon is a physician designated by U.S. Citizenship and Immigration Services (USCIS) to conduct

immigration medical examinations for individuals applying for an immigration benefit in the United States.

You must have civil surgeon designation if you wish to conduct immigration medical examinations in the United States,

except for medical officers of the U.S. Public Health Service. If you are not designated as a civil surgeon by USCIS, you

are not authorized to conduct immigration medical examinations for immigration benefit applications in the United States

or to complete USCIS Form I-693, Report of Medical Examination and Vaccination Record.

Civil surgeon designation does not authorize you to conduct immigration medical examinations for individuals seeking

immigration benefits abroad through the visa issuance process of the U.S. Department of State (DOS). Those immigration

medical examinations are conducted by DOS-designated panel physicians overseas. For more information, visit the DOS

website at

and search for “Panel Physicians.”

Who Should Use Form I-910?

Form I-910 should be used by a physician who is not currently designated, but who is seeking designation to perform

immigration medical examinations in the United States and to complete Form I-693.

NOTE: Physicians who qualify for blanket civil surgeon designation provided by USCIS are not required to apply for

civil surgeon designation on Form I-910. For information on blanket civil surgeon designations, visit

What Professional Qualifications Are Required For Civil Surgeon Designation?

In order to be designated as a civil surgeon by USCIS, you must:

1. Be licensed without restriction as a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) in the state in which

you seek to perform immigration medical examinations;

2. Have at least four years of professional experience as a physician; and

3. Be authorized to work in the United States.

Are There Other Requirements For Civil Surgeon Designation?

In addition to meeting the professional qualifications, you must:

1. Apply for civil surgeon designation using Form I-910;

2. Submit the completed Form I-910 with the correct filing fee; and

3. Have an active practice at the locations where you are requesting to perform immigration medical examinations.

USCIS will not grant your civil surgeon designation for locations where you only intend to practice in the future.

Form I-910 Instructions 12/23/16 N

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