I-910

Application for Civil Surgeon Designation

Agency
USCIS
Revision
Edition 01/20/25
Fillable fields
216
Pages
9
Official source
USCIS form page
Checked
October 20, 2026
Fill I-910 online
Page 1 of form I-910

Form I-910: Application for Civil Surgeon Designation

Form I-910, Application for Civil Surgeon Designation, is used by physicians seeking designation as a civil surgeon. The instructions describe a civil surgeon as a physician designated by USCIS to conduct immigration medical examinations for people applying for an immigration benefit in the United States, and to complete Form I-693, Report of Medical Examination and Vaccination Record.

The instructions say civil surgeon designation does not cover medical examinations for people applying for visas abroad through the U.S. Department of State, which only DOS-designated panel physicians perform.

The USCIS page notes that USCIS may exercise discretion in approving designations, and the instructions say meeting the listed qualifications does not guarantee designation. Military physicians and state and local health departments that fall under the limited blanket designations do not need to apply.

Top of page 1 of Form I-910: Application for Civil Surgeon Designation, as printed by USCIS

What's on Form I-910

Part 1: Information about you

Any previous designation, revocation or voluntary termination, full legal name, other names used, date of birth, sex, USCIS online account number and A-Number.

Part 2: Clinical office locations

Clinic or practice name, physical address, county, telephone, fax, email, website, languages spoken and mailing address. USCIS shows this location information to people looking for a civil surgeon.

Part 3: Status in the United States

One box for U.S. citizen or national, lawful permanent resident, or nonimmigrant, with arrival, Form I-94, passport and EAD details for a nonimmigrant.

Parts 4 to 6: Degrees, licenses and experience

A chart of medical schools and degrees, a chart of state or territory licenses with good standing, and employers covering at least four years of practice.

Parts 7 to 10: Signatures and extra space

The applicant's statement and certification, including agreement to follow 42 CFR Part 34 and the CDC Technical Instructions, then the interpreter and preparer sections and additional information space.

How to fill out Form I-910

  1. 1

    Complete the fields USCIS checks

    The USCIS page lists fields whose absence leads to rejection: the previous designation question, name, date of birth and sex in Part 1, the clinic name, address and telephone in Part 2, one box in Part 3, one full entry in Parts 4 to 6, and the Part 7 phone, signature and date.

  2. 2

    Attach degree and license copies

    The instructions ask for a copy of the original medical school diploma and each medical license, with a certified English translation for a foreign diploma. An ECFMG certificate is not accepted for the diploma.

  3. 3

    Document four years of practice

    The instructions say internship and residency do not count toward the four years, but a post-residency fellowship does. Evidence can include employment letters on letterhead, evaluations or fellowship certificates.

  4. 4

    Use N/A, None and Part 10

    Type or print in black ink. Write N/A where a question does not apply and None for a zero. Extra answers go in Part 10 with your name, CSID if any, and the page, part and item number.

  5. 5

    Sign Part 7

    A stamped or typed name is not accepted, and the instructions say the signature is kept on record to verify signatures on Form I-693. The form notes it is filed while in the United States. This page lets you fill the form online free, then print it to sign.

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Where to file, evidence and fees

Filing by mail

The USCIS page lists the Dallas Lockbox: by USPS to USCIS, Attn: I-910, P.O. Box 660812, Dallas, TX 75266, and by FedEx, UPS or DHL to USCIS, Attn: I-910 (Box 660812), 2501 S. State Highway 121 Business, Suite 400, Lewisville, TX 75067.

Edition

The USCIS page lists edition 01/20/25 and asks that every form in the package be the current acceptable edition, with all pages from the same edition, or the form may be rejected.

Fee

The fee is on the USCIS Fee Schedule page (Form G-1055), which can change. Check it on the day you file.

Initial evidence

The USCIS checklist names proof of immigration status, copies of medical degrees and current U.S. state or territory medical licenses, and proof of at least four years of practice as an M.D. or D.O. The checklist itself is not sent.

Status evidence

The instructions name a U.S. passport, birth certificate or Certificate of Naturalization, a Form I-551 with Form I-90 evidence if it is being renewed, or Form I-94, passport and EAD copies for a nonimmigrant.

After designation

The instructions say to notify USCIS within 15 days of changes such as address, practice location or license restrictions. The USCIS page gives [email protected] for changes to a designation.

Related forms

Who files Form I-910?

  • Licensed physicians

    The instructions list an active and unrestricted M.D. or D.O. license in the U.S. state or territory where the exams will take place, at least four years of professional experience as a physician in the U.S., and authorization to work in the United States.

  • Physicians with an active practice

    The instructions say USCIS will not grant designation for locations where the physician intends to practice only in the future or no longer practices. Each listed clinic is a current practice in the United States.

  • Previously designated civil surgeons

    Part 1, Items 1 to 7 are only for applicants who were designated before. They give the CSID, the period of designation, and any revocation or voluntary termination with an explanation in Part 10.

  • Who does not use this form

    The instructions say military and public health department physicians who qualify for blanket civil surgeon designation do not use Form I-910, and USPHS medical officers do not need civil surgeon designation.

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Questions about Form I-910

What is a civil surgeon?

The instructions describe a civil surgeon as a physician designated by USCIS to conduct immigration medical examinations for people applying for an immigration benefit in the United States and to complete Form I-693.

Does residency count toward the four years of experience?

No. The instructions say not to count post-graduate training in an internship or residency program, but time practicing on the basis of a post-residency fellowship can be counted.

Can a civil surgeon examine visa applicants abroad?

No. The instructions say civil surgeon designation does not cover examinations for the Department of State visa process abroad, which only DOS-designated panel physicians perform.

Can Form I-910 be filed online?

The USCIS page lists filing with the USCIS Dallas Lockbox by USPS or by courier and does not list online filing.

What is the Form I-910 filing fee?

USCIS fees change, so this page does not list one. The I-910 page points to the USCIS Fee Schedule, and the instructions point to Form G-1055.

Can USCIS revoke a civil surgeon designation?

Yes. The instructions say USCIS may revoke a designation at any time, with reasons such as no longer meeting the qualifications, not following the CDC Technical Instructions, fraud, or a risk to public health or safety.