Obtaining a green card is a major milestone for immigrants seeking lawful permanent residency in the United States. The process is often complex and lengthy, involving multiple steps including petitions, documentation, background checks, and a medical examination. While each applicant’s journey may vary slightly based on the immigration category they fall under—whether through employment, family sponsorship, asylum, or other categories—the process typically follows a structured progression.
The final stage of the green card process is arguably the most crucial, as it determines whether an applicant will officially be granted permanent residency status. In this blog, we will break down the final stage of the green card process in detail, explaining what it involves, what applicants can expect, and how to prepare for it.

Understanding the Green Card Process: A Quick Overview
Before diving into the final stage, it’s helpful to understand the broader green card application process. In general, the process consists of the following steps:
- Filing of Petition (I-130 or I-140): A sponsor, such as an employer or family member, files a petition with U.S. Citizenship and Immigration Services (USCIS).
- Priority Date: Once the petition is approved, the applicant is given a priority date, which determines their place in line for a green card (especially important in oversubscribed visa categories).
- Visa Bulletin and Waiting Period: Applicants must wait for their priority date to become current according to the Visa Bulletin published monthly by the Department of State.
- Adjustment of Status (Form I-485) or Consular Processing: When the priority date becomes current, the applicant can apply to adjust their status in the U.S. or attend an interview at a U.S. consulate abroad.
The Final Stage: Adjustment of Status or Consular Interview
The final stage of the green card process depends on whether the applicant is already in the United States or is applying from abroad:
- Adjustment of Status (AOS): For those already in the U.S., this is done through filing Form I-485.
- Consular Processing: For those outside the U.S., the final step involves attending an interview at a U.S. embassy or consulate.
Let’s examine each of these two final paths in detail:
Adjustment of Status (Form I-485): The Last Step Inside the U.S.
For applicants already in the U.S., the last step is to file Form I-485, Application to Register Permanent Residence or Adjust Status. This form officially requests the change of status from a non-immigrant or temporary immigrant to a lawful permanent resident.
Key Components of the Final Stage via Adjustment of Status
- USCIS Receipt Notice
Once Form I-485 is submitted, USCIS sends a receipt notice confirming they have received the application. This notice includes a receipt number that allows the applicant to track the status of their case online. - Biometrics Appointment
The applicant will be scheduled for a biometrics appointment, during which fingerprints, a photograph, and a signature will be collected. These are used to conduct background checks. - Request for Evidence (RFE), If Applicable
USCIS may issue an RFE if any supporting documents are missing or need clarification. This could include the immigration medical examination report (Form I-693) if it wasn’t submitted initially. - Immigration Medical Examination (Form I-693)
A civil surgeon designated by USCIS must complete the medical exam. It ensures the applicant does not have any conditions that would render them inadmissible on health-related grounds. - Interview Notice
Most applicants are required to attend an in-person interview at a local USCIS field office. During the interview, the officer will review the application, ask questions, and verify eligibility. - Final Decision
After the interview, USCIS will either approve, deny, or request additional information. If approved, the applicant will receive an approval notice followed by the physical green card in the mail.
Consular Processing: Final Stage Outside the U.S.
Applicants applying from outside the United States will complete the final stage through Consular Processing, which is coordinated between the National Visa Center (NVC) and a U.S. embassy or consulate in the applicant’s home country.
Steps Involved in the Final Consular Processing Stage
- Document Submission to NVC
Once the petition is approved and the visa number is available, the applicant is required to submit civil and financial documents to the National Visa Center. - Visa Interview Appointment
The applicant receives an appointment for a visa interview at the designated consulate. This notice includes details of required documents, including the medical examination results. - Medical Examination by a Panel Physician
The applicant must undergo a medical exam by a panel physician approved by the U.S. Department of State. The results are either sent directly to the consulate or handed to the applicant in a sealed envelope. - Visa Interview
During the interview, the consular officer will review all submitted documents, ask questions, and evaluate the applicant’s eligibility for an immigrant visa. - Visa Issuance and Entry to the U.S.
If approved, the applicant is issued an immigrant visa, allowing them to travel to the U.S. Upon arrival at a port of entry, they are admitted as a lawful permanent resident. The physical green card is then mailed to their U.S. address.
Green Card Approval: What Happens Next?
Regardless of whether an applicant adjusts their status within the U.S. or goes through consular processing, the final outcome is the same: official approval of lawful permanent residency.
After Green Card Approval
- Receive Green Card by Mail
The physical green card is mailed to the approved address and serves as proof of the individual’s lawful permanent resident status. - Rights and Responsibilities
New green card holders gain the right to live and work permanently in the U.S., travel freely, and apply for certain benefits. However, they must also comply with tax laws, carry proof of residency, and maintain lawful status. - Conditions on Residency (if any)
Some green cards are issued on a conditional basis (such as those based on marriage less than two years old). These require the filing of a petition to remove conditions before the card expires.
Common Reasons for Delays at the Final Stage
Even at the final stage, several factors can delay the approval process, such as:
- Background check complications
- Incomplete documentation
- Medical exam issues
- Interview rescheduling
- Pending RFEs
It is important to respond to USCIS or the consulate promptly and accurately to avoid setbacks.
Tips to Ensure a Smooth Final Stage
- Be prepared for the interview: Review your entire application beforehand and bring all original documents.
- Complete the medical exam on time: Schedule the exam early and use only designated civil surgeons or panel physicians.
- Keep documentation organized: Maintain clear records of receipts, notices, and correspondence.
- Respond to any RFEs quickly: Provide all requested documents within the specified timeframe.
- Monitor case status: Use the USCIS online case tracker or NVC communications to stay informed.
Conclusion
The final stage of the green card process is the most critical, culminating in either adjustment of status or consular processing, depending on the applicant’s location. This stage includes interviews, background checks, a required immigration medical exam, and ultimately, the decision to grant lawful permanent residency.
At Immigration Medical Exam Center, we understand the importance of the medical examination in this final step. Our experienced civil surgeons are USCIS-designated and ready to help you meet this requirement efficiently and professionally. Preparing carefully and staying informed at this stage can make the difference between approval and unnecessary delays.
Let this final step be your gateway to a new chapter as a permanent resident of the United States.