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N-648, Medical Certification for Disability Exceptions. Use this form if you are applying for U.S. citizenship and need to request an exception to the English and civics testing requirements for naturalization because of physical or developmental disability or mental impairment.
The Immigration and Nationality Act provides for special consideration of the civics test for applicants who, at the time of filing their Form N-400, Application for Naturalization, are over 65 years old and have been a permanent resident for at least 20 years.
An applicants difficulty in fulfilling the requirements, such as illiteracy in his or her native language, is not sufficient by itself to support a finding of eligibility for the exception.
There are certain exemptions to the civics test requirement for naturalization in the United States. These exemptions are based on age, physical or developmental disabilities, or medical conditions that prevent an individual from learning or demonstrating knowledge of U.S. history and government.
A licensed medical professional must complete a Medical Certification for Disability Exceptions (Form N-648) and certify, under penalty of perjury, that the applicants physical or developmental disability or mental impairment prevents the applicant from meeting the English requirement, the civics requirement, or both
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The decision to waive the interview should be made on a case-by-case basis. The interview enables USCIS to verify important information about the applicant to determine eligibility for adjustment.

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