In each part the chapters start with number 1. In each chapter the pages and paragraphs start with number 1, so that changes may be made in one chapter without affecting other chapters. At the foot of the page the part number and chapter number are given, to facilitate finding the page; these numbers precede the page number, and are separated from it by a dash. The Roman numeral designates the part; the first Arabic numeral designates the chapter. Thus, on page I-3-1: The "I" shows that the page is in part I. The "3" shows that the page is in chapter 3. xi When a change to the manual has been received and entered, a notation should be made below. This affords a simple check on the receipt of numbered changes. 1. At consulates.-All persons whom the consular authority presents for medical examination shall be given an intensive examination. 2. In the United States, its territories, and possessions.1—Intensive examinations shall be made of: a. Aliens who, as a result of medical inspection (see ch. 2, this part), are referred or detained for further examination. b. Aliens presented for reexamination or preexamination. 3. Refusal to be examined.-When an alien refuses to submit to medical examination, medical officers shall neither examine him nor pass upon the validity of any claim to exemption, but shall refer him to the presenting authority with a written statement of the reason no examination was made. 'Throughout this manual, procedures specified for United States ports are also applicable at stations in Canada when, at the request of the Immigration Service, persons to whom visas have been issued are given final examination for admission to the United States. Procedure 4. The intensive medical examination shall be a complete examination to determine the existence of any possible physical or mental disease or defect. Whenever practicable, it shall be made with the individual completely divested of clothes; in this matter due regard shall be given, of course, to medical ethics and the possible practical value anticipated of the procedure in individual cases. The female assistant routinely examines the abdomen, genitalia, and lower extremities of female aliens; only when he deems it necessary shall a male medical officer make the examination of these parts of the female body (in the presence of the female assistant; see sec. 34.3 of Regulations for the Medical Examination of Aliens). 5. During examinations, including examination of the eyes, the physician shall exercise all due precautions to prevent spread of disease. Facilities for this purpose shall include an approved antiseptic solution, soap, and a supply of small hand towels for frequent cleansing of the examiner's hands. 6. In all cases the examination shall include a urinalysis; this shall consist of qualitative tests for albumin and sugar and, when indicated, a microscopic examination. 7. The regulations (sec. 34.4) impose the requirements for chest X-ray and blood serology on immigrants as defined in the Immigration Act of 1924 that is, persons applying for admission to the United States for permanent residence and foreign students coming to an approved school. ༈ ཟསར་ཁ a. The following list gives the principal groups of aliens to whom these requirements apply, and shows the type of visa document presented by the aliens: (1) Quota immigrants under sections 5 and 6 of the Immigration Act of 1924-visa application form 256-A. -་་ ་ (2) Nonquota immigrants under section 4 of the Immigration Act of 1924—visa application form 256-A. NOTE.—When an immigrant previously lawfully admitted to the United States is returning from a temporary visit abroad, he may be referred for medical examination at the consulate in some cases. In such cases the alien will present form 256-A. However, these aliens may be exempted from the X-ray and blood-test requirements at the discretion of the examining medical officer, who shall record on medical form FS-398 the reason for exemptions. (3) Aliens preexamined in the United States who will proceed to Canada to obtain form 256-A and apply for reentry. b. Section 34.4 (b) of the regulations does not apply to aliens entering the United States for a temporary period or in transit; most such aliens will possess visa application form 257 A, B, and D. When medically indicated, X-rays and blood serological tests will of course be made of nonimmigrant aliens referred for medical examination at consulates or arriving at United States ports. c. At consulates the examiner should not place the X-ray reading and blood serological report as separate documents in the envelope with form FS-398,' but should merely enter them on that form; he should enter the complete X-ray reading, using the reverse of form FS-398 when necessary. When a United States Public Health Service medical officer signs form FS-398 at the consulate (even though the X-ray work was performed by a laboratory not attached to the consulate), essentially negative films may be returned to the visa applicant for disposition, and need not be carried to the United States. d. On arrival at the United States, aliens who have been examined at consulates present medical form FS-398, properly executed. Aliens subject to the requirements of section 34.4 (b) of the regulations also present the X-ray film (except that when form FS-398 is signed on the last line by a medical officer of the United States Public Health Service the alien need not present the substantiating X-ray film). The medical officer making the examination at the United States port reviews X-ray films presented; if both the report and film are essentially negative, and if there is no indication of need for further X-ray examination of the chest, the film is returned to the alien for disposition. e. When an alien arrives at a United States port without having complied with the requirements for chest X-ray and blood 1Regarding use of FS-398, see ch. 3, par. 1, this part, and part IV, ch. 2, par 1a. |