USCIS applies a high level of scrutiny to disability exemption requests submitted with naturalization applications. Medical certifications must clearly demonstrate that the condition is medically determinable, has lasted or is expected to last at least 12 months, and directly prevents the applicant from learning or demonstrating English or civics knowledge.

USCIS may issue Requests for Evidence or deny applications when Form N-648 is incomplete, inconsistent, vague, or lacks sufficient medical explanation. Applicants are encouraged to ensure their medical evaluation and documentation are accurate and thorough before submission.

When seeking a medical certification for a disability exception for naturalization, USCIS provides the following guidance. Applicants should understand these requirements before proceeding with an N-648 evaluation.

There is no filing fee charged by USCIS for Form N-648. However, medical professionals may charge a fee for the medical evaluation and for completing the required documentation.

Form N-648 may only be certified by a licensed Medical Doctor (MD), Doctor of Osteopathy (DO), or Clinical Psychologist who is authorized to practice in the United States. Applicants may verify a medical professional’s license through their state medical board.

An authorized medical professional must evaluate the applicant in person, or where permitted by state law, through a real-time telehealth examination, and must diagnose a physical, developmental, or mental impairment that prevents the applicant from learning or demonstrating English and civics knowledge required for naturalization.

The applicant must read and sign the Applicant’s (Patient’s) Attestation and Release of Information section of Form N-648. If the applicant is unable to sign due to a qualifying disability, a legal guardian, surrogate, or designated representative may sign on their behalf.

• Applicants should always refer to official USCIS guidance for the most current policies and instructions related to Form N-648.
  

Why is Form N-648 required for naturalization due to disability?

Form N-648 allows a licensed physician to medically certify that an applicant has a qualifying physical, developmental, or mental impairment that prevents them from meeting the English and civics requirements for U.S. citizenship. USCIS uses this certification to determine whether an applicant qualifies for a disability exception during the naturalization process.

How much does the N-648 MEDICAL EVALUATION cost in Orlando?

Initial N-648 Consultation

$275

The initial consultation includes a review of the patient’s situation, medical history, available records, and whether the case may be appropriate for Form N-648.

Total Cost If Approved

$1,250

If the doctor determines that the case is appropriate and the clinic is able to proceed with the N-648 medical certification process, the total cost is $1,250.

The initial $275 consultation is applied toward the total cost if the patient is approved to move forward.

Important Note

Not every patient qualifies for Form N-648. The doctor must review the medical condition, documentation, and USCIS requirements before determining whether the clinic can proceed.

There is no USCIS filing fee for Form N-648. The pricing above is for the medical evaluation, record review, and completion process at Sunshine State Medical.

Working With Other Qualified Medical Professionals

In some cases, applicants may already be under the care of a qualified medical professional for the condition related to the disability exemption.

When appropriate, Sunshine State Medical can review and work with existing medical evaluations or documentation from licensed and qualified medical professionals to help complete Form N-648 accurately and in compliance with USCIS requirements.

All documentation must meet USCIS standards, and the final certification must clearly explain how the diagnosed condition prevents the applicant from meeting naturalization requirements.

Who is allowed to complete and certify Form N-648?

Form N-648 may only be completed and certified by a licensed Medical Doctor, Doctor of Osteopathy, or Clinical Psychologist authorized to practice in the United States. USCIS does not accept certifications from unlicensed providers or providers outside these categories.

Is there a USCIS filing fee for Form N-648?

No. USCIS does not charge a filing fee for Form N-648. However, medical professionals may charge for the medical evaluation, record review, and completion of the required documentation.

Is an in-person exam required for the N-648?

Yes. USCIS requires that the applicant be evaluated in person, or through a real-time telehealth visit where state law permits. The medical professional must personally evaluate the applicant and diagnose the qualifying condition.

Does Sunshine State Medical work with outside doctors or specialists?

Yes, when appropriate. If an applicant has existing medical records or evaluations from a licensed and qualified medical professional, our clinic can review and consider this documentation as part of the N-648 evaluation process. All information must meet USCIS documentation standards.

Does the N-648 exam require blood work, urine tests, or vaccines?

No. Form N-648 does not require blood tests, urine tests, tuberculosis screening, or vaccinations. Those requirements apply only to the I-693 Immigration Medical Exam.

Does Form N-648 need to be sealed like the I-693?

No. Form N-648 does not require a sealed envelope. However, the applicant must appear in person to verify identity and sign required attestations before the form can be completed and released.

Official USCIS Resources

For the most current and official information, applicants should refer to:

USCIS Form N-648 Instructions

USCIS Official Form N-648