Updates to Medical Form N-648 for U.S. Citizenship — What You Need to Know Starting June 13, 2025

If you’re applying for U.S. citizenship but can’t pass the English and/or civics test due to a physical or mental disability, it’s important to know that you may be eligible to submit Form N-648.

This medical certification form allows you to request an exemption from the usual English and civics requirements. Recently, this form underwent some major changes.

What is Form N-648?

Form N-648 is a medical certification completed by a licensed physician. It allows an applicant to be excused from the English language and civics knowledge requirements when filing Form N-400 (the application for naturalization).

Key changes effective June 13, 2025:

— Shorter and simpler:

The form has been reduced from 9 pages to just over 4, making it much more streamlined.

— Simplified section on impairments (Part 3):

Details about the diagnosis and how it impacts the applicant’s ability to take the test are now combined into a single section.

— New section on understanding the Oath of Allegiance:

There is now a dedicated section where the doctor must evaluate whether the applicant understands the meaning of the Oath of Allegiance to the United States.

— Must be filed together with Form N-400:

Previously, you could submit this form after filing your citizenship application. Now, it must be submitted at the same time as Form N-400.

— Increased scrutiny:

USCIS has officially announced it will more rigorously verify the authenticity of medical statements, including potential additional requests for evidence and interviews.

Other important updates:

— You no longer need to list the exact dates of diagnoses.
— You don’t have to describe the severity of the impairments.
— You aren’t required to disclose the personal relationship between the doctor and the patient.
— Telemedicine evaluations are now allowed.
— You can indicate the need for an oath waiver directly on the form — no separate form is required.
— The form continues to be free of charge.

What to keep in mind:

USCIS may request extra evidence, including the involvement of a legal representative, especially if the doctor indicates that the applicant does not understand the Oath of Allegiance.