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State Dept. Updates Visa Medical Examination Forms


Updated visa medical forms are now being used. The forms are:

  • DS-2053 – Medical Examination for Immigrant or Refugee Applicant (1991 TB TIs)
  • DS-2054 – Medical Examination for Immigrant or Refugee Applicant (2007 TB TIs)
  • DS-3024 – Chest X-Ray and Classification Worksheet (1991 Centers for Disease Control (CDC) Technical Instructions (TIs) on tuberculosis (TB))
  • DS-3030 – Chest X-Ray and Classification Worksheet (2007 TB TIs)
  • DS-3026 – Medical History of Physical Examination Worksheet (all posts), and
  • DS-3025 – Vaccination Documentation Worksheet (all posts).

The Department of State recently released a cable sent to the field in June 2009 listing the forms and noting that all posts should begin using the DS-2053, DS-3024, DS-3026, and DS-3025 forms immediately, and discontinue use of any older version of these forms. Medical exams that have been completed using the older version of the forms, however, do not have to be repeated.

The cable is available at http://travel.state.gov/visa/laws/telegrams/telegrams_4550.html. Related information from the CDC, including CDC global TB control activities for U.S. immigration and TIs for TB screening and treatment, is available at the CDC website. Other CDC information on proposed vaccination criteria for U.S. immigration, and guidelines for medical examination of immigrants, is available at this site.

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