Refugee Medical Screening


Refugee Medical Screening


A refugee medical screening (RMS) also known as a health assessment is an important first step for refugees and new commers resettling in the U.S. to receive medical care. The screening should be done within 90 days of arriving in North Dakota.

The goal of the refugee medical screening is to support and promote the health and well-being of refugees that arrive in North Dakota. The Health and Human Services Office of Refugee Services team trains health care providers to provide the best care possible to refugees and newcomers arriving in North Dakota. 

The medical screening is a comprehensive physical examination of all family members and an opportunity to identify any physical and mental health concerns that could prevent you from employment, attending school, gaining economic self-sufficiency, and integration. During the visit, health care providers will also refill medication and help ensure you have a primary care doctor and provide referrals to specialty doctors if needed. 

Screenings are performed by medical providers and may take two visits, that include: 

  • Review of your overseas medical examination
  • Assessment of current health 
  • A physical examination
  • Lab work
  • Immunizations 

Please complete all testing and pick up your medications (if any) before leaving the clinic. Your medical screening may require a second visit. Arriving for future follow-up appointments and completing your subsequent appointments on time is crucial.

Screening results do not effect immigration status. The purpose of the screening is to help you stay healthy and are able to successfully settle in North Dakota.

Schedule a screening

General Questions

General Questions
How is the refugee medical screening different from an overseas medical examination?

The overseas examination is primarily limited to identifying medical and mental health conditions that prevent resettlement in the U.S. This can include communicable diseases, physical and/or mental conditions associated with harmful behaviors, substance abuse, or addiction. 

The purpose of the refugee medical screening is to support the health and well-being of refugees that have already undergone the overseas examination and have resettled in North Dakota.

Are only refugees eligible for a refugee health assessment?

No, all Office of Refugee Resettlement (ORR) eligible populations, such as Ukrainian humanitarian parolees, Cuban Haitian entrants, Special Immigrant Visa (SIV) holders, asylees, and certified victims of human torture, are eligible for these visits. This visit is also for people of every age. 

What should I bring for the refugee health assessment?

Bring the following items for you and your family if you have them:

  • I-94 and identification cards 
  • Overseas medical records
  • Vaccination records
  • Any medications or herbs you may use 
How much does the refugee health assessment cost?

You do not have to pay for the refugee health assessment as long as you complete your assessment with the Office of Refugee Services contracted provider, who may also be your primary care provider. Medicaid or Refugee Medical Assistance (RMA) will cover the cost. 

In certain cases, there may be a nominal co-pay, and depending on the household income, there may be a client share for RMA-eligible clients. 

What is a primary care provider?

Your primary care provider is the first stop for medical care. A primary care provider is a doctor or nurse practitioner that you and your family should see for a routine checkup or non-emergency medical care. Primary care in the U.S. means having one regular doctor who takes care of you and your family’s ongoing health care needs and, if necessary, refers you to a specialist.

How do I prepare for the refugee medical screening?
  • Bring documents such as I-94s, identification cards, passports, medical records, vaccination records, etc., that you may have for yourself and your family. 
  • You and your family are typically scheduled on the same day for your medical screening appointments. Depending on the size of the family, it may take longer to complete the visits. Pack necessary items such as medications, snacks, extra diapers, or anything else you may need while waiting. 
  • Arrive on time as instructed by the medical screening provider or your case manager. Arriving late will result in cancellations of your appointment/s. Notify your case manager as soon as possible if you need to reschedule due to an emergency or urgent need. 

Please seek assistance from your case manager regarding transportation or other barriers that may prevent you from keeping your appointment.

What should you expect at the refugee health assessment?

Check in with the staff person at the front desk. 

  • You will complete the paperwork. This is a normal practice for any new patients. Please request an interpreter if necessary. 
  • You and your family may have to wait before you are directed to an exam room where the doctor and nurse/s will meet all family members. 
  • You may have to provide your and your family’s name and date of birth multiple times during this visit. This is to ensure proper identification. It may be helpful to have the birthdates written down. 
  • Please note that medical screenings may require blood tests and vaccinations. 
  • Please do not leave except in an emergency. If you need to use the bathroom, do not hesitate to ask where they are. 
  • Please complete all testing and pick up your medications (if any) before leaving the clinic. Your medical screening may require a second visit. Arriving for future follow-up appointments and completing your subsequent appointments on time is crucial. 
What are your rights during the refugee health assessment?
  • You have the right to free interpretation services. These can be in-person or virtual. 
  • You have the right to express your desire to be seen by a doctor of a specific gender. Ask your case manager before the appointment. They can contact the clinic beforehand to make arrangements. 
  • You have the right to privacy, covered under U.S. HIPAA law. All your personal and health information will remain confidential. 
  • The health care clinic may have its own rights and responsibilities document that you can request.
What is the difference between a refugee health assessment and other types of visits?

A refugee medical screening involves many different things that are not usually done by providers during normal clinic visits. This includes testing for and treating illnesses that are more common in different countries and reviewing immunization and medical records from other countries

How do I schedule a refugee medical screening?

You can submit a request to schedule a screening here or you can contact the Office of Refugee Services, State Refugee Health Coordinator by email at or by phone at (701) 298-4663, and we will connect you to a case manager and local health care provider to schedule an appointment.

Do the results of a refugee health assessment affect my immigration status?

No. This visit is only to help you stay healthy and has no effect on immigration status


North Dakota Civil Surgeons

Understanding the Role of the Civil Surgeon and Adjustment of Status for Refugees

Refugees who have been physically present in the U.S. for one year may complete medical evaluations (examination) to adjust their status and obtain a “Green Card” or Legal Permanent Residence status. The medical evaluation for refugees differs from that of immigrants; therefore, confirming the individual's legal status is critical before proceeding. 

The medical immigration examination must be completed by a civil surgeon (a physician designated by U.S. Citizenship and Immigration Services or USCIS) or their designee. The medical director of local public health may complete the form for applicants through a blanket waiver designation with refugee status only. This blanket waiver designation does not extend to Asylees or Cuban/Haitian/Afghan parolee applicants, nor does it extend to any other applicant for adjustment of status. Regardless of the status, the USCIS Form I-693 must be completed, signed, and submitted in a sealed envelope for all applicants. 

Validity of the USCIS Form I-693 

The I-693 form must be filed with USCIS no more than 60 days before filling the Form I-485, Application to Register Permanent Residence or Adjust Status. 

The I-693 form must be filed with USCIS within 60 days of signature. It is valid for two years, only when filed within 60 days of signature. Once accepted, it is then valid for up to two years while the USCIS adjudicates the application. Forms filed after 60 days of signature or completed incorrectly are invalid, and the application will be rejected. 

Note: Under certain circumstances, USCIS may provide all applicants temporary waivers from the aforementioned requirements. 

For Refugees 

  • Refugees who arrived to the U.S. without a Class A condition will be required to update vaccinations only. The civil surgeon or the public health designee must complete the I693 Form, Part 10. Vaccination Record. 
  • Refugees who only need to complete the vaccinations, must complete and submit the following sections of the I-693 form. 
    • Part 1: Information about you. 
    • Part 2: Applicant’s statement, contact information, certification, and signature. 
    • Part 3:Interpreter’s contact information, certification, and signature- If  interpreter is utilized. 
    • Part 4: Contact information, declaration, and signature of the person preparing the application, if other than the applicant. 
    • Part 5: Applicant’s identification information. 
    • Part 7: Civil surgeon’s contact information, certification, and signature.
    • Part 10: Vaccination record 
  • Refugees who arrived to the U.S. with a Class A condition must complete the entire medical immigration examination, including vaccinations. The examination must be conducted by a civil surgeon. 

For Immigrants, including Asylees and Parolees 

  • A complete medical immigration examination is required by a civil surgeon. 

North Dakota civil surgeon list: 

Note: The exam and administrative fees are not covered by insurance and vary between civil surgeons. Contact the clinic for details. 

Family Health Care 
Dr. Napoleon Espejo 301 NP Avenue 
Fargo, ND, 58103 
(701) 271-3344 

Essentia Health 
Dr. John Mickelson 
1100 19th Avenue N 
Fargo, ND, 58102 
(701) 364-5757 

University of North Dakota, Center for Family Medicine 
Dr. Jeffrey Hostetter 
Dr. Swami Gade 
701 E. Rosser Avenue 
Bismarck, ND, 58501 
(70) 751-9500 

Sanford Health- Occupational Medicine 
Dr. Krissondra Klop 2603 E. Broadway Avenue 
Bismarck, ND, 58501 
(701) 323-5222 

Trinity Medical Group, Health Center- Medical Arts 
Dr. Howard Reeve 400 E. Burdick Expressway 
Minot, ND, 58701 
(701) 857-7840

For more information:

I-693, Report of Medical Examination and Vaccination Record 
CDC Technical Instruction for Civil Surgeons- Medical History and Physical Examination 
CDC Technical Instructions for Civil Surgeons- Vaccinations
CDC Technical Instructions for Civil Surgeons- Tuberculosis