Medical Certification for Disability Exceptions (N-648)

USCIS N-648 Disability Waivers – Fast, Affordable, and Completed by Licensed Providers at The Urgent Care.

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General Process

What Do I Bring To My Visit?

  • Government-issued photo ID (passport, driver’s license, green card, or state ID).
  • Your USCIS A-number (from your immigration documents).
  • Medical records from your treating physicians, clinics, or hospitals that describe your condition.
  • List of current medications and dosages.
  • Any previous psychological or neurological evaluations  (if applicable).


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  • Comprehensive medical evaluation by a USCIS-certified provider to assess your physical, developmental, or mental condition.
  • Detailed review of your medical history, including any prior diagnoses, treatments, medications, or hospitalizations.
  • Cognitive or mental-status screening, if applicable, to document how your condition affects memory, learning, communication, or functioning.
  • Review of supporting medical documentation (doctor’s notes, psychological reports, imaging, lab results, etc.) to verify consistency with your diagnosis.
  • Completion of Form N-648 with all required information and medical justification explaining how your condition prevents you from meeting the English and civics requirements.
  • Official certification and signature by the civil surgeon (doctor) in compliance with USCIS standards.
  • Optional review and copies of the completed N-648 form for your records before submission with your N-400 citizenship application.

Why Choose TUC?

Choose The Urgent Care for your USCIS-approved N-648 Disability Waiver evaluation and benefit from compassionate, high-quality service at an affordable price. Our experienced, certified providers make the process simple and respectful, ensuring that each evaluation is completed accurately and in full compliance with USCIS requirements.

We provide comprehensive medical assessments to document qualifying physical, developmental, or mental conditions that may prevent an applicant from meeting the English or civics test requirements. Our team reviews all supporting medical records, conducts the necessary examination, and completes the N-648 form clearly and professionally for submission with your citizenship application.

No insurance is required, and there are no hidden fees—just honest, reliable care from a trusted local provider.

For over 20 years, The Urgent Care has been dedicated to serving our community with professional and compassionate healthcare. We are committed to helping you navigate the N-648 process with confidence, accuracy, and understanding—making your path to citizenship as smooth and stress-free as possible.

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Frequently Asked Questions

What is the N-648 or “Disability Waiver”?

The N-648, also called the Medical Certification for Disability Exceptions, is a form that allows certain U.S. citizenship applicants to be excused from demonstrating that they can read, write, and speak basic English and/or pass the U.S. civics test.
 This waiver is only available for individuals with a diagnosed medical condition that prevents them from meeting those requirements.
 If approved, applicants may:

  • Have their citizenship interview in their native language, and/or
  • Be exempt from answering the U.S. history and government questions.

To ensure a smooth and efficient visit, please bring the following items to your immigration physical appointment:

  • Photo ID (passport, driver’s license, or government-issued ID)
  • Medical Record (medications, 
  • Any immigration-related notifications or letters received from USCIS, as they need to be included in the sealed envelope.

Bringing complete documents helps ensure a smooth and timely process.

Who qualifies for an N-648?

To qualify, all three of the following must apply:

  1. The person has a physical or developmental disability or mental impairment;
  2. The condition has lasted or is expected to last at least 12 months; and
  3. The condition prevents the person from learning English and/or civics.
  • Complete medical examination by a civil surgeon

Our experienced health care professionals will discuss your health and counsel you on preventative care and healthy choices.

How can The Urgent Care help?

At The Urgent Care, our USCIS-certified medical professionals:

  • Conduct full N-648 evaluations
  • Review your medical records and confirm eligibility
  • Complete and sign your USCIS Form N-648

We offer affordable, same-week appointments and compassionate care to help make the process stress-free.

What types of medical conditions qualify?

The condition must be a “medically determinable” physical or mental impairment that makes learning or recalling information impossible.
Examples include:

  • Alzheimer’s disease or other forms of dementia
  • Down syndrome and other cognitive impairments
  • Severe psychiatric or developmental conditions
  • Serious illnesses (like cancer with chemotherapy side effects) that affect concentration or learning
Do I need to bring a translator?
  • You are welcome to bring your own translator if you prefer, especially if you feel more comfortable communicating in your native language. However, The Urgent Care has bilingual staff members who speak Spanish and can assist you during your visit if needed.
When should I submit the N-648?

You should submit the N-648 form together with your N-400 (citizenship application).
 Submitting them at the same time helps avoid delays.

Who can fill out the N-648 form?

Only the following licensed professionals in the U.S. can complete the form:

  • Medical Doctors (M.D.)
  • Doctors of Osteopathy (D.O.)
  • Clinical Psychologists

The provider must personally examine the applicant and be licensed in the U.S. or its territories.

What should my doctor include on the N-648?

USCIS reviews whether your medical provider clearly demonstrated that your condition prevents you from:

  • Reading, writing, or speaking basic English, and/or
  • Learning and understanding U.S. history and government.

A USCIS officer will review your N-648 at the beginning of your naturalization interview.

How does USCIS decide whether to approve the waiver?
  • You will find out during your citizenship interview.
    If the officer accepts your N-648, you can continue your interview in your preferred language.
When will I know if my waiver is approved?

If your N-648 is approved:

  • Your interview will proceed in your native language (with an interpreter, if needed).
  • USCIS will waive the English and/or civics test requirements.
  • The officer will continue evaluating the rest of your eligibility for naturalization.
What happens if my waiver is accepted?

If denied, your citizenship interview will continue without the waiver.
You’ll be given the opportunity to take:

  • The English test, and
  • The U.S. civics test.

You will have two chances to pass — once during your initial interview and again during a re-examination.
If you decline to take the tests, it will count as a failed attempt.

What happens if my N-648 is denied?

Your medical provider must:

  • State your diagnosis and describe how it was made (including tests or evaluations used)
  • Explain how your condition affects memory, learning, focus, communication, or comprehension
  • Clearly connect your medical condition to your inability to learn English or U.S. civics
  • Confirm that the condition has lasted or is expected to last at least 12 months

USCIS prefers the form to be written in plain language that non-medical officers can easily understand.

How soon can I schedule an appointment for N-648 medical exam?

Appointments are by schedule only. For more information, see above or contact us via text or call at 504-344-8444.

Get Started Today

For questions or assistance, contact our medical exam specialist at immigration@theurgentcare.com or call (504) 334-8444 

We’re here to make the process smooth and stress-free!

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