Medical Examination Instruction

Important Notice:

• Immigrant visa applicants should complete their medical examinations with authorized physicians before their scheduled interview dates.  If you complete your medical examination after your visa interview, processing of your immigrant visa case will be delayed until the U.S. Embassy or Consulate has received your medical examination results.  Therefore, applicants are strongly encouraged to complete their medical exams prior to their visa interviews.
• Medical forms are not available to the public.  We have sent several copies to the appointed clinic and the clinic will make copies as appropriate.

A list of authorized physicians for the U.S. Embassy Jakarta is provided in the list below.

Dr. Retno Asti Werdhani
Medikaloka Clinic
Graha Irama Building, Mezzanine and 2nd Floor
Jl. HR Rasuna Said Block X‐1, Kav. 1‐2
Tel. 021‐526‐1118
Hours: 16.00 – 20.00 Monday thru Wednesday

Dr. Indrayati Handojo
Medikaloka Clinic
Graha Irama Building, Mezzanine and 2nd Floor
Jl. HR Rasuna Said Block X‐1, Kav. 1‐2
Tel. 021‐526‐1118
Hours: Monday thru Wed and Friday 08.00‐16.00; Thursday 12.00 – 20.00; Saturday 8.00 - 13.00

Dr. Hendrik Wiraatmaja
Medikaloka Clinic
Graha Irama Building, Mezzanine and 2nd Floor
Jl. HR Rasuna Said Block X‐1, Kav. 1‐2
Tel. 021‐526‐1118
Hours: Monday thru Thursday 08.00‐16.00; Friday 14.00 – 20.00; Saturday 08.00 – 13.00

Dr. Narain Punjabi
International SOS
Jl. Puri Sakti No. 10, Cipete, Jakarta Selatan
Tel. 021‐750-5980
Hours: Monday and Friday 09.30‐15.00; Tuesday thru Thursday 11.30 – 16.15; Saturday 8.30 - 12.00

Dr. Rini Sutanty
International SOS
Jl. Puri Sakti No. 10, Cipete, Jakarta Selatan
Tel. 021‐750-5980
Hours: Monday, Wed, Friday and Saturday 09.00 – 16.00

Dr. Stephanus Iman
International SOS
Jl. Puri Sakti No. 10, Cipete, Jakarta Selatan
Tel. 021‐750-5980
Hours: Monday, Wed, Friday 15.00 - 22.00; Saturday 09.00 - 17.00

Medical examinations performed by non-authorized physicians will not be accepted.  

The medical examination includes a review of the applicant's medical history, physical examination, chest X-ray, and blood tests.  The authorized physician will either give the applicant the medical examination results to hand-carry to the visa interview or will send the results directly to the U.S. Embassy or Consulate.

Be sure to bring the following to your medical examination:

1. Passports of all family members applying for visas (original and copy)
2. One photograph of each applicant

All visa applicants regardless of age need a medical examination.  Children under age of 14 will not need a chest x‐ray or serological test unless required by the examining physician.

Medical examinations are taken at your own expense.  They remain valid for purpose of visa issuance for six (6) months.

X‐RAYS

1. For Pregnant Women.  If you suspect that you are pregnant, please advise the examining physician in order that special precaution can be taken if a chest x‐ray is require.
2. Previous X‐rays.  While previous x‐rays are not normally required medical clearances, applicants who have them in their possession are advised to bring them to the clinic.  This will save considerable inconvenience for applicants who need their previous x‐ray results, as a decided by the examining physician for comparison purposes.

VACCINATIONS

If you have written record of vaccine history you may present your record to the examining physician to be determined whether you have received a complete series of each required vaccine.