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| INSTRUCTIONS FOR MEDICAL EXAMINATIONS | ||||||||||||||||||||||||||||||||||||||||||||
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In order to be able to formally apply for an immigrant visa, a medical examination is required. This examination consists on one x-ray and a blood test for applicants age 15 or older. To get these exams done you have to go to one of the laboratories mentioned below, taking your passport and this instructions with you. The x-ray exam is not required in cases of pregnant women. Applicants must pick up their exams’ results from the laboratories in order to be able to get the general medical examination done. This exam is mandatory for ALL applicants, no matter their age. In order to be able to get your general medical examination done, you must go to see one of the doctors mentioned below. You have to take your passport and the letter from the NVC (if applicable, since if your petition was filed at post or you are applying for a fiancé/e K1 visa, the appointment will be scheduled by the Consular Section) with your appointment date and time to the doctor’s appointment. You have to ask for an appointment date and time at the clinic/s and to the doctor via telephone before going in person. Please remember to mention that the exams are the ones required for the United States Immigrant Visa. These exams will not be given to the applicants. The doctor is in charge of bringing them to the Consular Section at the Embassy of the United States in Montevideo. The fees for all medical tests and exams are to be paid by the applicants. Doctors:
Laboratories:
IMPORTANT NOTICE FOR IMMIGRANT VISA APPLICANTS CONCERNING VACCINATION REQUIREMENTS Recent changes to United States Immigration Law now require Immigrant Visa applicants to obtain certain vaccinations (listed below) prior to the issuance of an immigrant visa. Instructions and procedural guidance Panel physicians who conduct medical examinations on behalf of immigrant visa applicants are now required to verify that the applicants has met the new vaccination requirement, or that it is medically inappropriate for the applicant to receive one or more of the listed vaccinations: Mumps, Measles, Rubella, Polio, Tetanus and Diphtheria Toxoids, Pertussis, Influenza Type B (HIB), Hepatitis B, Varicella, Pneumococcal and Influenza. In order to assist the panel physician and to avoid delays in the processing of the immigrant visa, all visa applicants should have their vaccination records available for the panel physician’s review at the time of the medical examination. Visa applicants should consult with their regular health care provider to obtain a copy of their immunization record, if one is available. If you do not have a vaccination record, the panel physician will work with you to determine which vaccinations you may need to meet the requirement. Certain waivers of the vaccination requirement are available upon the recommendation of the panel physician. Only a physician can determine which of the listed vaccinations are medically appropriate for you, given your age, medical history and current medical condition. It is advisable that you postpone all vaccinations until you have your medical interview. In the event that you require any of the following inoculations, you should be aware that there are additional fees:
HIV TESTING If you are age 15 or older, a blood test for the antibody to the Human Immunodeficiency Virus (HIV) is required as part of your medical examination. HIV is the virus that is the cause of the Acquired Immune Deficiency Syndrome (AIDS). AIDS is the name given to the group of illnesses which may occur in persons infected with HIV. Infection with HIV causes a defect in person’s natural immunity against disease. This defect leaves infected people vulnerable to serious illnesses that would not usually be a threat to anyone whose immune system was intact. This test is not to diagnose AIDS but to detect antibodies to the virus. If the result is positive, it does not necessarily mean that you have AIDS or will get it. The results of your test will be provided to a Consular Officer. Important Notice for HIV positive immigrant visa applicants Ineligibility according to United States law: Section 212(a)(1)(A)(i) of the United States Immigration and Nationality Act prohibits immigrant visa issuance to any person who is afflicted with a communicable disease of public health significance. Human Immunodeficiency Virus (HIV), that may derive to the Acquired Immune Deficiency Syndrome (AIDS), is one of those illnesses. As part of the general medical exam required for immigrant visa applicants, the doctor tests all applicants age 15 or older for HIV infection. In those cases in which the doctor may have reason to believe that a child younger than 15 years old may be HIV positive, a blood test may be required. Overcoming the Ineligibility: An HIV positive applicant, who is the husband/wife, son/daughter (regardless of age) or minor child of a United States Citizen or Legal Permanent Resident (LPR) (green card holder), or who has a son/daughter that is a US citizen or LPR, can apply for a waiver of the grounds of excludability. The Consular Officer will determine if a qualifying relationship exists. If this relationship exists, the Officer will inform the applicant regarding the waiver request. It is important to remember that it is the US Immigration and Naturalization Service (USCIS) and not the Consular Officer the agency that has the authority to decide whether a waiver request is approved or rejected. How to apply for a waiver: If an applicant qualifies for a waiver, the Consular Officer will provide him/her with an information package, containing form I-601. The applicant must complete page 1 of the form and give it back to the Consular Officer. The Consular Officer will send the form to the U.S. Center for Disease Control and Prevention (CDC) in Atlanta, Georgia. CDC will register the necessary information and send back form I-601 along with a supplementary form (attached to the back of form I-601), to the Consular Officer. The Consular Office will give the supplementary form to the applicant, who will have to complete the sworn statement A of the form and send the form to his/her sponsor in the United States. The sponsor must assure that the sworn statement gets completed B by the doctor who will treat the applicant in the United States. If the sworn statement C is completed by a private practice doctor, the sponsor must make sure that the form is endorsed by a local or state health officer. Once all of these steps are completed, the sponsor must send the form back to the Consular Officer. The applicant must pay a waiver processing fee of U$S 545 in cash. The Consular Officer will ask the applicant for a check addressed to DHS or will charge the fee in cash and will give a receipt to the applicant. The Officer will then send the immigrant visa waiver request to the Department of Homeland Security (DHS). If the waiver is approved, the Department of Homeland Security (DHS) will notify the Consular Officer and the applicant. If DHS grants the waiver request and the applicant has no other ineligibilities, the Consular Officer will contact the applicant and issue the Immigrant Visa. Other Ineligibilities: Some HIV positive immigrant visa applicants are also subject to other ineligibilities. While an HIV positive applicant who has a qualifying relative can apply for a waiver, the Consular Officer may not approve such waiver until other possible ineligibilities have been resolved. Sometimes the applicant may apply for more than one waiver at the same time; the applicant may have another ineligibility that cannot be overcome, that makes it impossible for the Consular Officer to issue a visa, even if the applicant overcomes the HIV ineligibility. The Consular Officer can inform the applicant of any other ineligibility that he/she may have. Public Charge: As per Section 212(a)(4) of the United
States Immigration and Nationality Act, an immigrant visa applicant
must prove that he/she has the financial resources adequate to
cover for their expenses while in the United States and therefore
prevent the need of public assistance. In cases of HIV positive
applicants, it might be difficult to cope with that requirement
of the law, since the cost the HIV treatment is very expensive
and because it is likely that the applicant may not be able to
work or have health insurance. The Consular Officer must be satisfied
that the applicant has access to sufficient funds as to cover
for his/her expenses and will take into account the family income
and other available funds, medical insurance that covers all expenses
HIV related, the availability to public health services and hospitalization
in which there are no provisions to charge the patients for the
fees and any other relevant factor. There is no waiver available
to overcome this ineligibility. However, if the applicant can
demonstrate that he/she has acquired an additional insurance or
enough funds as to overcome this ineligibility, the Officer can
conclude that the ineligibility does not apply anymore. For information
regarding HIV positive treatment and care, consult with a doctor
or public health officer in your country. CHANGES TO DNA RELATIONSHIP TESTING PROCEDURES GENERAL INFORMATION ON DNA TESTING Deoxyribonucleic Acid (DNA) testing is the most accurate and widely available technology to test a biological relationship. The types of tests used by the DNA scientific community continue to evolve; currently, the Polymerase Chain Reaction-Short Tandem Repeat (PCR-STR) and the Restriction Fragment Length Polymorphism (RFLP) methods are the two tests that we believe to be the most advanced, offering the best results. These tests are preferred over older technologies such as human leukocyte antigens (HLA) and human blood alleles (ABO) blood typing because they do not require blood samples and are more accurate when all parties are not available for testing and/or when the other possible father (in a paternity case) or mother (in a maternity case) is thought to be related to the tested party. DNA TESTING COLLECTION METHOD The preferred specimen collection technique for DNA testing is by buccal (cheek or mouth cavity) swab. When buccal swabs are taken, cells are collected from the inside cheek using a long cotton swab. Cheek swabs are preferred over blood samples because they are easier to collect, non-invasive, painless, and easier to ship. The accuracy of a DNA test conducted with a cheek swab is equivalent to a test conducted using a blood test, and, unlike blood, cheek swabs are not considered to be bio-hazardous. SELECTION OF AABB LAB Any DNA testing for visa or citizenship purposes must be processed by a lab that is accredited by the American Association of Blood Banks (AABB). Names of AABB accredited labs can be found here. Please note that the list of laboratories on the site is based on the physical location of the lab's headquarters, and the operations of most labs are not restricted to that location. Therefore, the petitioner should be able to choose from the full list of AABB laboratories that conduct DNA testing. The petitioner must select an AABB-accredited laboratory, contact the lab directly, and make the necessary arrangements for conducting the genetic test - including payment for all tested parties. Under no circumstances should petitioners use third-party vendors to select their lab, arrange appointments, or transport the specimens outside of the lab chain-of-custody controls. For example, a petitioner must independently choose his or her own AABB lab, make the appointment, and go to the collection site directly. The collection site must then send the specimen to the main AABB lab testing site directly, through the lab's internal, controlled system. Third-party vendors include, but may not be limited to, private companies or clearinghouses that serve as intermediaries to make appointments on behalf of petitioners or beneficiaries. The authority for collecting DNA specimens in the United States resides exclusively with the AABB labs and their directly affiliated collection sites. Under no circumstances should petitioners, including those in
the United States, directly receive test kits STANDARDS FOR THE COLLECTION OF THE DNA SAMPLES Though advanced, DNA results are only accurate if strict standards are followed for every sample collected. The AABB establishes standards for relationship testing, and the Department of State follows these standards for use in the collection of DNA samples to verify relationships for IVs, passports, and other benefits based on biological relationships. There are four essential elements that must be understood and maintained to protect the integrity of the DNA collection and relationship testing procedures: --As DNA testing is voluntary, the individual being tested must consent to the testing; --The identity of the individual being tested must be verified and confirmed by a cleared American; --The integrity of the sample must be maintained through a strict chain of custody; and --The actual collection of the DNA sample must be witnessed by a cleared American. All DNA collections must take place at the embassy or consulate and not at the panel physician's office or other lab facility. Department of State medical officers may not collect biological samples for genetic testing purposes. Furthermore, under no circumstances should consular officers attempt to collect samples themselves. All sample collection must be done by medical personnel employed by the panel physician. Consular management must approve each lab technician prior to his or her authorization to collect DNA samples from applicants. Each panel physician's office must recommend several lab technicians who will then be cleared and approved by post. DNA TESTING PROCEDURES Petitioner/putative parent selects AABB accredited lab. The selected AABB lab sends the beneficiary DNA testing kit(s) directly to the consular section. The Accountable Consular Officer (ACO) checks in all test kits on the DNA accountability log upon receipt in the consular section. This consists of ensuring that the kit has not been opened or damaged and if the kit includes a seal, confirming the kit seal is intact, adding the kit to the accountability log stored in the ACO safe, and storing it in the ACO safe or a bar lock cabinet. The safe where the DNA kits are stored must be accessible only to the ACO or designated backup. Once the ACO records receipt of the collection kit, the consular section must contact the applicant to schedule an appointment date for DNA collection and tell the applicant that he/she must bring his/her passport and a photograph. On the DNA collection appointment date, a lab technician from the panel physician's office must come to the consular section to collect the DNA sample(s). Immediately prior to the testing, the ACO checks the test kit
out of the safe and gives it to the cleared American witness who
will witness the collection, recording the cleared American witness's
name in the accountability log. The witness verifies that the
kit is unopened, and if applicable, the seal is intact. The COMMUNICATING THE RESULTS OF THE DNA TEST In all phases of testing, communication of the results of the test must be directly between consular officers or cleared Americans and the laboratory. AABB laboratories will send all test results directly to consular sections in envelopes sealed with the same type of security tape used when samples are taken. Only a consular officer or cleared American may open the sealed envelopes and perform step (1) below. A cleared American receives and opens the sealed DNA results letter, and enters the results of the test into the case notes, taking care to record the probability of relationship determined by the testing. Since the applicant or sponsor bears full financial responsibility for testing, we have no objection to that person also receiving a copy of the results directly from the laboratory or panel physician. Post should not give copies of DNA test results directly to petitioners, applicants, or other parties without express consent from the Department. | ||||||||||||||||||||||||||||||||||||||||||||
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