TIPS FOR MEDICAL PROFESSIONALS - Form N-648, 2025

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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
After completion of the medical examination, the civil surgeon will give the applicant, the completed Form N-648 in a sealed envelope. The Sealed Envelope is Opened only by USCIS officials. The Seal should Never be Broken by the Applicant , his or her lawyer or any other Individual.
Citizenship Test Disability Accommodations If a healthcare provider completes the required Form N-648, individuals may be exempt from the English and civics tests. Accommodations are also available for those with medical disabilities or impairments who are seeking extra help or support during their test-taking.
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.
A disability exception, which can only be requested by submitting Form N-648, requires an applicant to show that the applicants physical or developmental disability or mental impairment prevents the applicant from complying with the English or civics requirements or both, even with reasonable accommodations.
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An immigration officer may deny an N-648 for insufficiency, lack of credibility, fraud, or material misrepresentation. If your N-648 is denied simply for being insufficient, the immigration officer will proceed with your interview as if you had not submitted an N-648 (testing you on English, civics, and so forth).
Only a medical doctor, doctor of osteopathy, or clinical psychologist licensed to practice in the United States may certify Form N-648. You may contact your state medical board to determine whether the medical professional has a valid license.

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