Health Considerations

Many children who become available for intercountry adoption have special needs or identified medical conditions. Those needs and medical conditions can be challenging for a family that is not prepared. We urge you to carefully consider a child's medical condition and special needs before accepting a referral.


Children eligible for adoption often have health conditions that are common in developing countries but that can be prevented in the United States. Some children have more serious conditions, such as tuberculosis and HIV. In addition, children's health is often negatively affected by living in an institution.


The type and quality of available medical information about a child can vary greatly between countries. Your adoption service provider should provide you with as much information as possible about the health of a particular child, but it will not be able to guarantee that the information is complete or up-to-date. Typically, the information about a child eligible for adoption will be more comprehensive from Convention countries than from non-Convention countries.

Convention Adoptions

If you are adopting a child from a Convention country, your accredited adoption service provider is responsible for providing you with an English-language translation of the child's medical records as part of the “Article 16 report.” The Article 16 report is prepared by a competent authority in the child’s Convention country of origin and includes the child’s psychological, social, and medical history, in addition to medical records. Your accredited adoption service provider will provide this information to you no later than two weeks before you are asked to accept or decline a referral.


Accredited adoption service providers must make reasonable efforts to obtain available information, including the following:

  • The date that the Convention country or other child welfare authority assumed custody of the child and the child's condition at that time;
  • History of any significant illnesses, hospitalizations, special needs, and changes in the child's condition since the child came into custody;
  • Growth data, including prenatal and birth history;
  • Specific information on the known health risks in the specific region or country where the child resides;
  • If a medical examination of the child is arranged, the date of the examination, and the name, contact information, and credentials of the physician who examined the child;
  • Information detailing all tests performed on the child;
  • Current health information;
  • Information about the child's birth family and prenatal history, cultural, racial, religious, ethnic, and linguistic background;
  • Information about the child's past placements prior to adoption;
  • Information about any birth siblings; and
  • Dates on any videotapes and photographs taken of the child.

NOTE: Unless extenuating circumstances involving the child's best interests require a more expedited decision, an accredited adoption service provider may not withdraw a referral until you have had two weeks to consider the medical and social needs of the child and your ability to meet those needs.

Medical Exam for a Visa

Every immigrant visa applicant, including children adopted by or in the custody of U.S. citizen parents, must undergo a medical examination by a physician who has been designated by the Department of State. The U.S. embassy or consulate can provide a list of such physicians, called "panel physicians," within the foreign country. Establishing medical eligibility for an immigrant visa is a requirement of Sections 212(a) and 221(d) of the Immigration and Nationality Act (INA).


Prospective adoptive parents should not rely on the panel physician’s medical examination to detect any other medical conditions beyond those specified in the INA. The scope of the medical examination is, by law, very limited. The purpose of the limited medical examination is to provide the U.S. government with information regarding persons with serious infectious or contagious diseases. It is not designed to evaluate the child's overall health or to provide medical care for the child. It will not provide adequate information on the child's short-term and long-term medical needs. Thus, adoptive parent(s) may wish to arrange an additional, private medical examination of the child.


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