Citizenship Test Waiver (Form N-648)

For individuals with physical, developmental, or mental impairments who are seeking citizenship in the United States, the usual educational requirements for English language proficiency and civics knowledge can be waived. To qualify for this waiver, the applicant must be able to demonstrate that their disability or impairment prevents them from meeting these requirements, even with reasonable accommodations. This means that their condition must significantly affect their functioning and ability to demonstrate the necessary educational knowledge for citizenship.

This page covers everything you need to know about obtaining a medical exception for your naturalization application. You’ll find answers to important questions, such as

Why you should trust our services?

1. We have been providing USCIS exams since 2007.
2. We conduct over 1,500 I-693 exams annually.
3. We regularly conduct N-648 exams and coordinate collection of supporting records from patients and their providers.
4. Our exams are personally conducted by one of our certified U.S. civil surgeon physicians.
5. Our exams are comprehensive, lengthy, and tailored to effectively demonstrate your case to the USCIS.
6. We gather relevant background information and records, as well as other supporting details to strengthen your case.
7. Our staff is empathetic, and supportive, and has years of experience working with international patients.
8. We are skilled in working with your legal team, as well as your current and previous healthcare providers, to meet your needs.
9. We provide quick turnaround for your paperwork, and an expedited option is also available.
10. We meticulously review all applications before sending them out to ensure that each application:
a. Explains the nature and extent of the medical condition and how it relates to the applicant’s inability to meet the requirements.
b. Attests that the medical condition has lasted or is expected to last for at least 12 months and is not related to illegal drug use.
c. Includes a formal clinical diagnosis with relevant ICD or DSM diagnosis code.
d. Documents the clinical and laboratory measures used to arrive at the conclusions of the reported condition.

What you need to bring to your exam?

  1. Government-issued photo identification, such as a passport, state ID card, or driver’s license.
  2. Medical records related to your impairment or disability, such as lab results, imaging studies, psychological testing results, or progress notes from your physician or psychologist.
  3. Contact information for your current physician or psychologist, as well as any other healthcare provider or caregiver who can provide information about your impairment.
  4. If possible, before your appointment, give those providers permission to disclose medical information to Paritda Corona Medical Center using the Permission to Disclose form (PDF, 1 page). This may help reduce the time it takes to complete your paperwork.
  5. A translator if you are unable to speak or understand English.

What the cost will be?

The initial exam and paperwork comprise:

  • Comprehensive medical examination.
  • Verification and certification of prior health records.
  • Documentation of disability status.
  • Completion of N-648 paperwork.
  • Secure electronic storage of records.

The N-648 exam requires extra paperwork and involves additional expenses compared to a regular medical exam. The process of organizing and completing the necessary paperwork can be time-consuming. Additionally, depending on the results of the exam, there may be further costs for required lab studies or diagnostic tests.

We'll also address the issue of payment and whether or not insurance covers the cost?

Payment for healthcare services related to immigration is due at the time of the appointment since they are not typically covered by health insurance policies. We do not bill insurance for these services.

What are the prerequisites to avail an exception?

  • Lack of proficiency in the English language and civics education due to reasons other than an impairment.
  • Impairments caused by drug use.
  • Impairments that have not lasted for at least 12 months.
  • Impairments that are not expected to last for at least 12 months.
  • Impairments that do not affect your ability to meet the English language and civics education requirements, such as hearing or vision impairments.
  • Low literacy or lack of literacy.
  • Advanced age.

What factors could be considered as qualifying conditions for a medical exception?

Qualifying for a medical exception depends on the severity and specific nature of the impairment for each individual. The mere presence of a medical diagnosis or condition is not sufficient for an exception. The medical condition must significantly and consistently impair the individual’s learning, memory, language acquisition, or ability to communicate. For instance:

  • Progressive neurological conditions like multiple sclerosis (MS), Parkinson’s disease, and dementia.
  • Acquired neurological injuries such as strokes, brain tumors, lesions, and traumatic brain injury.
  • Developmental disorders that have been present since birth, including ADHD, learning disabilities, and certain types of autism.
  • Severe mental health conditions such as schizophrenia, major depression, specific anxiety disorders, and bipolar disorder.


What occurs during the medical exam process?

The length of the exam depends on the specific nature of your impairment. Typically, the exam takes approximately 50 minutes and includes:

The duration and components of the exam depend on the specific impairment.

Generally, it includes;

  • a physical examination
  • collection of vital signs
  • an impairment-focused interview
  • and potentially laboratory tests, including drug testing
  • Additional assessments, such as psychological evaluations or medical imaging, may be prescribed as well.

  • Any medical or psychological records you provide will be examined. We may also request to speak with your family members, caregivers, or other healthcare providers who have treated you to gather additional information, if necessary, through telephone communication.

When can I expect to receive my documentation?

“The time required to complete your paperwork largely depends on the amount of supporting documentation you bring into the initial visit. Records from your primary care physician or specialists as well as imaging studies that corroborate the diagnoses, we are using to apply for the waiver are crucial to quickly finish the waiver application.) If additional lab studies or diagnostic tests are needed, the completion of paperwork may be delayed until the results are available. After we have received all the necessary clinical information, we can have it ready within a day to a week.”

Walk in Appointments Available Daily

We are offer walk-in appointments Monday – Friday 8am to 5pm.

Contact us

Call Us

(702) 708-4217

Email Us

Our Location

2950 E. Flamingo Road
Suite E.
Las Vegas,NV 89121


Get in touch

8 + 10 =