Stage 4: Medical Exam

1 day in London: 1–2 hours at the medical, plus the same-day document check at the embassy £400 base fee for adults, plus more depending on age and required tests or vaccines At least 10 working days before your interview Reviewed 18 Sept 2026

Bottom line

Stage 4: Medical exam. You have your interview date and need a medical before you can be interviewed. One clinic covers the whole United Kingdom: VisaMedicals in London. The medical must be at least 10 working days before your interview, and appointment windows open monthly and fill quickly. Budget a £400 base fee for adults, plus more depending on age and required tests or vaccines. Do this first: call VisaMedicals on 020 7486 7822 as soon as your window opens.

Action list

  1. Either: Book VisaMedicals as soon as the monthly window opens: 020 7486 7822 or bookings@visamedicals.co.uk. Have ready the full name and date of birth of all applicants, case (LND) number, visa category, interview date and ACRO police certificate.
  2. Beneficiary: Request a GP Summary Care Record timed within 2–3 weeks of the medical, and a printout of your vaccination records.
  3. Beneficiary: Complete the medical questionnaire (IV18a), and register your passport return on AIS to get the courier registration confirmation with its QR code.
  4. Beneficiary: If you have a significant medical or mental health history, get supporting reports from your treating clinician.
  5. Beneficiary: Keep the pink checklist slip safe after the medical. It is for the embassy document check, which is canceled until checks resume.

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All applicants must complete a medical exam with an approved panel physician before the interview. For the entire United Kingdom, the only approved clinic is VisaMedicals in London.

VisaMedicals: booking details

Address: 4 Ground Floor, Bentinck Mansions, 12–16 Bentinck St, London W1U 2ER

Buzzer: Look for "VisaMedicals" marked on the right-hand side of the building: buzz Flat 4

Phone: 020 7486 7822

Email: bookings@visamedicals.co.uk

Hours: Mon–Fri 09:00–16:30

Website: visamedicals.co.uk/united-states

VisaMedicals entrance at Bentinck Mansions

VisaMedicals entrance: Bentinck Mansions, 12–16 Bentinck St, London W1U 2ER

Timing and booking

The medical must be 10 working days before your interview. Visa Medicals appointment windows open monthly (e.g. May interviews can book from approximately 1 April). Book as soon as the window opens: slots fill quickly. You are required to attend the same-day embassy document check after your medical (window: 11:45 AM – 2:30 PM). Currently canceled: see the interview cancellation notice. VisaMedicals will contact the embassy on your behalf if you are running late. You will be charged £100 if you cancel within 3 working days of your appointment.

Have the following ready when you call to book: full name and date of birth of all applicants, case (LND) number, visa category, interview date, ACRO police certificate, and a contact phone number or email. The medical must be 10 working days before your interview date.

GP Summary Care Record

Request a GP Summary Care Record from your GP: timed within 2–3 weeks of your medical appointment. It should include applicant and GP details, significant medical history, current medications, ongoing problems. Some practices also include recent appointments and vaccination history. The summary care record and vaccination history does not need to be signed or stamped by the practice.

If you have a significant medical history (cancer, HIV, TB, depression, or other serious conditions), bring supporting reports outlining diagnosis, management, treatment, and current status. If anything further is required, the doctor will tell you on the day and you can email additional documents afterwards. VisaMedicals is understanding of a range of situations. Contact them with any questions ahead of time.

What to bring to the medical

  • Passport
  • Interview letter The email sent to you by NVC notifying you of your interview date and location.
  • DS-260 confirmation page
  • Courier registration confirmation (with QR code) Generated when you register your passport return on the AIS website (ais.usvisa-info.com).
  • Completed medical questionnaire (IV18a)
  • ACRO police certificate
  • GP summary dated within 2–3 weeks Does not need to be signed or stamped by the surgery or doctor: a printed or digital summary from your NHS record is sufficient.
  • Vaccination records Does not need to be signed or stamped: a printout from your NHS app or GP patient record is accepted.
  • Glasses or contact lenses (if applicable)
  • Medical reports for any chronic, serious, or mental health conditions (if applicable)
  • Psychiatric documentation (if applicable)
  • TB or STI records (if applicable)
  • Child health records (if applicable)

What happens at the medical

The medical examination assesses health-related grounds of admissibility. CDC guidance on the medical history and physical examination →

  • Check-in and digital photo
  • Document review
  • Chest X-ray (age 15+)
  • Blood test (age 18+)
  • Urine test (age 18+)
  • Physical examination (in a gown)
  • Vaccine review and administration

You will receive a pink checklist slip at the end. Bring this to the same-day embassy document check. Do not lose it. With document checks canceled, keep it safe until they resume.

Vaccinations

Common requirements: MMR, Tetanus/Diphtheria, Hepatitis A & B, Varicella (or documented history), Polio (within 12 months: see CDC Polio addendum for UK-specific requirements), Flu (Oct–Mar only). COVID-19 is no longer required. Hepatitis B requires three doses but you only need to have started the series: remaining doses can be completed in the US. Bring official documentation of past vaccinations; they will often take your word that you had chickenpox as a child.

Full CDC vaccination requirements for immigrants →

Vaccine waivers

If you decline vaccines for medical, moral, or religious reasons, a waiver is required via USCIS I-601. The waiver process takes approximately 36 months. Until resolved, your medical will be marked inadmissible.

Pregnancy considerations

Chest X-ray is required for age 15+. You can defer until after birth or after 12-week scan. No live vaccines (MMR, Varicella) during pregnancy. Deferrals may delay visa issuance.

Mental health

The medical includes a mental health assessment. Conditions such as depression, anxiety, and other mental health diagnoses are not automatically grounds for inadmissibility: the assessment focuses on whether a condition is associated with harmful behavior. If you have a mental health history, bring supporting documentation from your treating clinician.

CDC guidance on mental health assessment →
Transgender and non-binary applicants: document consistency

Under current US policy (effective April 2, 2025), USCIS recognizes only male and female sex markers on immigration documents. Sex is determined by what is recorded on the birth certificate issued at or nearest to the time of birth. The X gender marker option has been removed from all USCIS forms and documents.

If your documents carry different sex markers, for example, your UK passport or a legal gender recognition certificate reflects an updated marker that differs from your birth certificate, or your medical records differ from either. This is likely to cause delays or a Request for Evidence. The medical examination at VisaMedicals records sex as shown on your documents, which may create a further inconsistency in the case file.

Practical steps:

  • Before submitting to NVC or attending the medical, review all documents: birth certificate, passport, and any other identity documents, and identify any inconsistencies in the sex marker.
  • Where your documents are consistent, use the sex marker recorded on your original birth certificate on all immigration forms to minimize the risk of delays.
  • If you have document inconsistencies or your birth certificate does not list male or female, seek advice from an immigration attorney experienced in LGBTQ+ immigration before proceeding. Use the AILA directory to find one.

Support resources:

Official sources: USCIS April 2025 policy announcement  ·  USCIS Policy Manual: Vol. 1, Part E, Chapter 5  ·  This is a rapidly evolving policy area. Guidance reflects the position as of May 2026.

Medical fees (Dec 2025 prices)

CategoryFee
Adults 45+ (medical + X-ray)£400
Adults 25–44 (medical + blood)£430
Adults 18–24 (medical + blood + urine)£450
Children 15–17£365
Children 14 and under£250
Additional testsFee
Drug screen£95–£200
QuantiFERON TB Gold Plus£85
TB Sputum Test (x3)£130
DNA Test (Adult)£120
VaccinationsFee
Diphtheria, tetanus and pertussis£45
Tetanus and diphtheria and polio£45
Measles, mumps and rubella£50
Hepatitis B£55
Hepatitis A & Hepatitis B combined£80
Varicella£75
DTaP + Hib£75
Pneumococcal (Adult)£100
Pneumococcal (Child)£100
Influenza£25
Hepatitis A£65
Hepatitis A+B (Child)£80
Hepatitis B (Child)£40
Meningococcal MCV£70
Polio£60

Prices subject to change. Vaccines are billed separately if needed. Check VisaMedicals for current pricing.

Same-day embassy document check

After the medical, go directly to the embassy.

Embassy document check

Address: 33 Nine Elms Lane, London SW11 7US

Window: 11:45 AM – 2:30 PM. Go even if running late

Getting there from VisaMedicals:

  • Victoria line towards Brixton from Oxford Circus → Vauxhall, ~10 min walk: £3.10 contactless
  • Bus 2 towards West Norwood from Portman Sq → Vauxhall Bus Station, ~12 min walk: £1.75 contactless
Running late is not a problem

When you finish at the medical, the clinic lets the embassy know you are on your way. As long as you head straight there, there is no realistic chance of being turned away for the document check. The posted closing time is not something to worry about.

Finding the Pass Back window

Do not join the main visa queue. The document check happens at a separate window: the "Pass Back" window: on the south side of the embassy, and it is easy to walk straight past it.

1
Head for the south pavilion entrance
Aim for the south side of the building and the south pavilion entrance. If you are walking from Vauxhall station, it will be on your right.
2
Look for the security booth with guards in it
Coming from the Vauxhall direction, the Pass Back window is pretty much the first window you reach: just behind the security booth with guards inside.
3
Use the sign, not the podium, as your landmark
Earlier in the day there is a podium outside, sitting a little further forward than the window itself. Staff take the podium away shortly before the Pass Back window opens and put out a sign in its place, headed "PASSBACK" with a red arrow, reading "Immigrant/Fiancé(e) Visa Document Review, 11:45 AM – 2:30 PM" (the same sign also lists a separate 1:30–2:30 PM passport collection window, that one is not for you). That sign stands directly opposite the Pass Back window, so once you spot it, turn to face the building and the window is right in front of you. If you are looking for the podium and cannot find it, that is a good sign. It means the window is about to open.
4
Expect nothing to be happening if you are early
The line does not start forming until around 11:30–11:45 AM, and you cannot enter the embassy until roughly 11:45 either. An empty pavement when you arrive does not mean you are in the wrong place. It means you are early.
5
Check in at the window
Present your pink checklist slip and passport. Staff put a sticky note with a number on your passport and then direct you inside, once entry has opened. If you are unsure at any point, ask the guards or the staff at the head of the queue. They will point you to the right window.
US Embassy London exterior showing entrance doors (left) and PassBack window (right)

Entrance doors on the left, the Pass Back window on the right (with sign). Do not join the main queue. Go directly to Pass Back.

Once you are inside

The embassy is two buildings with an open courtyard between them, and the document check is upstairs in the second one. The route is signposted and staff will direct you, but it helps to know where you are heading.

1
Security in the first building
Airport-style screening in the first building you enter. Have your passport and DS-260 confirmation to hand.
2
Cross the open courtyard
Out of security, walk through the open courtyard to the second building.
3
Check in again at the desk
There is a desk in the second building where you are checked in a second time. They will direct you upstairs.
4
Out of the lifts: left, then left, then left again
Turn left out of the lifts, then left and left again. You will come to a small waiting area with three banks of seats facing a wall of booths. That is the document check, and it is the same room you will come back to for your interview, so it is worth registering the route now.
5
At the booth
When your number is called, your documents are checked and your fingerprints are taken at the same booth: all in one step. You will then receive a sealed "Do Not Tamper" envelope containing your documents; bring it, unopened, to your visa interview.

Documents are typically checked one by one: having them organized in separate sleeves or sections makes this smoother. Many members use one binder for the medical and a separate one for the embassy.

Bring to the document check

  • Passport
  • Pink checklist slip (from medical)
  • DS-260 confirmation page
  • Civil documents (originals)
Realistic timing

Medical arrival 8:40 AM → finished ~10:15 AM. Coffee break. Document check queue opens 11:45 AM → finished ~12:15 PM. The document check is usually quick and staff will confirm everything is in order: many members find this reassuring.

What not to bring

Community medical experiences

Reported by London channel members. All found the process professional and manageable.

Josie, March 13, 2025

Check-in: Greeted at the door. Submitted passport, Summary Care Record (SCR), and vaccine record.

Process: ~20 minute wait, then doctor reviewed history, took bloods, and conducted physical exam. Chest X-ray also completed. Two vaccines administered by nurse.

Check-out: Paid £475 by card. Received document check paper. Described as "really smooth and reassuring."

Tip: Use hand cream before the appointment: fingerprints scan more easily.

89cruefan, May 23, 2025

Check-in: Efficient check-in. Documents collected at reception.

Process: Chest X-ray, then doctor exam (bloods, height, skin checks). Order may vary by clinic schedule. Tetanus booster administered (previous dose 2016).

Special note: Latent TB history. Doctor accepted a summary letter from prior employer. No further testing required.

Check-out: Received document check paper for embassy. Described as "pretty quick and easy."

CF97, November 12, 2025 (9:30 AM appointment)

Check-in: Arrived at 08:55 for 09:30 appointment and were seen ahead of schedule. Note: they may call you in before your appointment time if they have capacity. Documents retained: passport and medical docs. Certificates scanned and returned. 2x2 photos brought but not required: photo taken onsite at reception. Additional questionnaire completed on arrival covering medical yes/no questions.

Process: Chest X-ray (~30 min wait), then doctor exam covering height, weight, eyesight, neck, chest, abdomen, bloods, and medical history (~20 min wait), then nurse for vaccine review and administration (~25 min wait). Left at 11:04.

Check-out: Tetanus booster (£40), Hep B (£40), Flu (£20). Total cost: £495. Received pink slip for embassy.

Aqua, February 2026 (9:00 AM appointment)

Check-in: Attended with a baby and husband (husband waited with baby during exam). Clinic confirmed in advance that bringing a baby and a companion was acceptable. Note: the building is not step-free, with two sets of wooden double doors and steps at each entrance. A pram requires assistance. Documents taken: passport, ACRO police certificate, vaccination records, medical questionnaire, interview appointment email printout, GP medical summary. Photo taken onsite.

Process: Nurse first for vaccine review, then chest X-ray (required to change into a gown), then doctor exam: questions about medical history, eyes and ears checked, chest listened to, sight test, weight, height, blood test. No urine test required. Partial Hep B series from before was accepted. Chickenpox history taken on word.

Check-out: £430 total (£400 base + £30 for blood test on applicant over 40). Received pink slip.

DVS, March 2026 (9:30 AM appointment)

Check-in: Arrived at 09:05 for 09:30 appointment and were seen early. Documents taken at check-in.

Process: Standard exam flow. Left at 10:50 (85 minutes total). Wife had four vaccine shots due to no documented childhood vaccination history.

Clinic note: If there are any issues with X-ray or blood results, they will contact you within 3–5 working days. No contact means all clear.

Check-out: Received pink slip. Embassy document check took ~30 minutes total.

Neri, March 2026

Check-in: "A breeze." Very efficient and supportive staff. Documents collected at check-in: passport, birth cert, police cert, vaccination record, interview letter, GP summary. Additional questionnaire completed on arrival.

Process: Standard exam flow.

Check-out: Pink slip issued. Embassy doc check completed successfully. Additional note: documents already uploaded to CEAC were not re-requested in paper form.

Engr Busted, March 2026 (9:50 AM appointment)

Check-in: Arrived at ~09:40: recommended to go in about 10 minutes early as there's an additional questionnaire to complete. Documents taken: passport, birth certificate, vaccination record, medical questionnaire, ACRO police certificate, interview letter page, GP summary. Photo taken at reception. Questionnaire completed on clipboard.

Process: Chest X-ray, then vaccines, then doctor check-up with blood sample. Order may vary based on staff availability.

Check-out: Received pink slip. Described as "quick and efficient." Straightforward experience despite initial anxiety about the appointment.

Naomi, March 2026

Process: Standard exam. Medical + X-ray only. All vaccinations completed in advance: a mix of private and GP-administered. Private vaccination record taken to GP for updating. Printed combined record accepted at the medical.

Check-out: Paid £430. Received document check paper.

Embassy doc check: Documents accepted without issue. Received originals back in sealed transparent envelope with instruction to bring to interview.

Nikki, June 24, 2026 (11:10 AM appointment)

Check-in: They prefer you arrive on time, not early. Photo taken (as honest assessment: "very shiny and sweaty with zero makeup!"). Required documents: passport, GP summary, vaccine history, ACRO police certificate, appointment email confirmation. Medical forms completed on arrival.

Process: Called back for different tests at different times depending on clinic schedule. Chest X-ray first, then vaccines, bloodwork, and GP screening. Staff adapted timing to keep appointment on schedule: when running behind, a nurse did the bloodwork instead of the doctor to stay on time. "Everyone was incredibly lovely and comforting. The blood test was painless. They love hearing about why you're moving."

Check-out: Given back passport, pink slip, and payment collected. Staff notified embassy if running late for document check: "No stress whatsoever!"

honfrog, June 24, 2026 (10:50 AM appointment)

Check-in: Arrived early (10:25), completed waiting room form. Staff were "so nice and easy, all professional and very kind." Reception had a checklist of required documents on display. Photo taken. Staff patient while finding documents. Urine sample required (age-dependent).

Process: Chest X-ray (~5 minutes, radiologist very nice). Hepatitis B vaccination by lovely nurse (especially appreciated: "not a fan of needles"). Panel physician took the longest, asking questions about medical history, drug use, and previous surgeries. Missing GP report for anxiety diagnosis was acceptable with CBT Confirmation and Current/Previous Medications documentation.

Check-out: Given pink slip and advised everything sent to embassy within ~5 days if bloods and X-ray were good ("no news is good news!"). Then payment.

Across all reported cases: medical typically 1–2 hours, embassy document check 15–45 minutes. Staff consistently described as professional, efficient, and supportive. Bring your appointment letter but don't arrive more than a few minutes early. Check-in happens only at your scheduled time.

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Before you move on

  • Beneficiary: My medical is at least 10 working days before my interview date.
  • Beneficiary: I have the pink checklist slip, and I know where it is.
  • Beneficiary: I have noted the date of my exam, in case a rescheduled interview falls outside the results’ validity window.
  • Either: VisaMedicals has not contacted me about X-ray or blood results within 3–5 working days. No contact means all clear.
  • Beneficiary: My sealed “Do Not Tamper” envelope from the document check is unopened for the interview, or, while document checks are canceled, my originals are kept together for when they resume.