USCIS has issued a new announcement regarding the status of Haitian children. The announcement and two USCIS documents can be found below.
The USCIS Office of Public Engagement understands that you are anxious to find out about the status of your application and wants to make sure that you receive the most accurate and up-to-date information. We are therefore forwarding two documents for you reference.
Please note that USCIS has established a special mailbox to address the questions and concerns of prospective Haitian adoptive parents and stakeholders. If you have a specific question regarding your case and are unable to find an answer to your question on our website (www.uscis.gov/haitianearthquake) please email inquiries to: HaitianAdoptions@dhs.gov. The adoption team is making every effort to respond to all inquiries within 48 hours. However, please note that the team receives a large number of emails and is therefore grateful if you can limit the number of emails you send so that the team can respond to everyone.
Interim Recommendations for Initial Domestic Medical Screening of
Haitian Orphan Parolees
NOTE: Will be updated as more information becomes available
DATE: February 1, 2010
PURPOSE: To provide medical screening recommendations for diseases of public health
importance in orphaned children entering the United States from Haiti under humanitarian parole
TARGET AUDIENCE: Domestic medical providers evaluating orphaned children being
evacuated from Haiti
The January 12, 2010 earthquake and multiple aftershocks created enormous devastation and
loss of life in the heavily populated city of Port-au-Prince, Haiti and outlying areas. Although the
exact numbers of deaths is still unknown it is estimated that more than 200,000 people lost their
lives since the event. There was an estimated 380,000 orphans in Haiti as of 2007, but since the
earthquake this number is unknown. (http://www.unicef.org/infobycountry/haiti_statistics.html).
The health status of orphans in Haitian orphanages is considered to be very poor. Even before
the earthquake, Haiti had a high prevalence of bacterial and protozoal diarrhea, hepatitis A and
E, typhoid fever, dengue fever, malaria, leptospirosis, tuberculosis, and HIV. On January 18,
2010, the Department of Homeland Security (DHS) announced a humanitarian parole policy
allowing orphaned children from Haiti to enter the United States to ensure that they receive the
care they need.
Normally, before admission to the United States, all internationally adopted children are required
to have a medical examination in their country of origin, specified by CDC, performed by a
physician designated by the Department of State. However, given the urgency of the current
situation, Haitian orphans entering the United States under parole status have been allowed to
bypass this overseas medical screening examination prior to departure. Therefore, this document
presents recommendations for screening for communicable diseases of public health importance
that is meant to take the place of the overseas medical screening exam– referred to hereafter as
the initial domestic medical screening for orphan parolees. This medical screening should be
performed as soon as possible after arrival and consist of a general medical screening, as well as
screening for tuberculosis (TB), vaccination status, HIV, intestinal parasites, malaria, syphilis,
and mental health. A subsequent more comprehensive medical evaluation is recommended in
accordance with the American Academy of Pediatrics guidelines on the Medical Evaluation of
Internationally Adopted Children for Infectious Diseases (Red Book®: 2009 Report of the
Committee on Infectious Diseases – 28th Ed. 2009). Although these examinations may be
performed together, the immediate screening described in this document should not be delayed to
accommodate the comprehensive examination.
INITIAL MEDICAL SCREEING
All orphans should have a medical history (if known) and physical examination. Components of
the medical history should include;
History of trauma
Symptoms of communicable disease (i.e. fever, coryza, cough, rash, diarrhea, vomiting)
Past medical and surgical history including any known chronic diseases
o Specific history of TB and HIV should be solicited
o Medication history
Components of the physical examination should include:
Vital signs and assessment of hydration status
Height, weight, head circumference (if age appropriate)
Obvious injuries that may have resulted from trauma
A full physical examination with particular attention paid to signs that may indicate
underlying medical problems such as heart disease, asthma, chronic malaria (e.g. tachycardia,
heart murmurs, labored respirations, abdominal tenderness) or undetected but subtle injury
from trauma (e.g. splenic rupture).
Assessment of nutritional status (looking for signs of malnutrition)
If fever is present, there should be a high clinical suspicion of malaria, dengue fever, and
typhoid. Consideration should also be given to detecting clinical conditions requiring isolation
(i.e. typhoid, TB, measles or chickenpox). Optimally, evaluation should be performed in
consultation with an expert in infectious diseases or tropical medicine.
Orphans with known chronic medical conditions (e.g. asthma, congenital cardiac conditions,
seizure disorders) should be carefully evaluated and treated, particularly since previous therapy
may have been disrupted. Orphans with known chronic cardiac and respiratory disease should
have vital signs assessed including oxygen saturation (portable oximeter) as soon as possible.
Orphans with diabetes should have a glucose measurement as soon as possible.
Further, in 2009, the Haitian National Nutrition Survey found an acute and chronic malnutrition
to be 4.5% and 24-35%, respectively.
Laboratory screening tests should include:
Complete blood cell count with red blood cell indices
Malaria smear (if symptomatic)
Stool examination for ova and parasites (3 specimens)
Stool examination for Giardia spp., Cryptosporidium, rotavirus antigen (if symptomatic);
strongyloides serology if eosinophilia
Syphilis serologic testing
o Non-treponemal test (RPR, VDRL, ART)
o Treponemal test (MHA-TP, FTA-ABS)
Serologic testing for vaccine preventable diseases (if indicated—see text)
Tuberculin skin test or Chest radiograph (see text)
The incidence of TB in Haiti is one of the highest in the Western hemisphere, at 306/100,000 for
all forms of TB. By comparison, the US rate is 4.2 per 100,000 (source: Global Tuberculosis
Control: epidemiology, strategy, financing: WHO report 2009.
Because of the high incidence of TB in Haiti, in addition to the living conditions of most
orphans, all orphan parolees should be evaluated for TB disease after arrival. This evaluation
should consist of medical history, physical examination, and if adequate follow up can be
guaranteed, screening orphans 2-14 years of age with the tuberculin skin test (TST) or
interferon-gamma release assay (IGRA) is recommended. Physicians should be advised that
some experts prefer TST in children younger than 5 years of age. There are relatively few
published reports documenting the performance of IGRAs in young children, obtaining sufficient
blood is more difficult, and there is concern that IGRAs may perform differently in very young
children who are at greater risk of a poor outcome if infection is undiagnosed. If the TST is ≥10
mm or IGRA is positive, a chest radiograph (CXR) (anteroposterior or posteroanterior view and
a lateral view for applicants <10 years of age; posteroanterior view for applicants ≥10 years of
age) should be performed.
If adequate follow-up cannot be guaranteed, the TST or IGRA can be omitted and a CXR can be
done as the initial screening test.
The following categories of children should provide sputum specimens:
Orphans with signs and symptoms of TB
Medical history suggesting TB
CXR findings suspicious of TB
Three sputum specimens (or alternative specimens such as gastric aspirates if the child cannot
provide sputum specimens) should be provided to undergo microscopy for acid-fast bacilli
(AFB), as well as culture for mycobacteria and confirmation of the Mycobacterium species, at
least to the M. tuberculosis complex level. Orphans diagnosed with TB disease should be started
on treatment with treatment delivered as directly observed therapy (DOT).
For any child requiring sputum specimens to be sent, the medical provider should contact the
local health department of the final placement location of the child, to ensure appropriate followup.
Once the orphans are in a long-term placement, those not diagnosed with TB disease and started
on DOT, and without documented TST or IGRA results from their initial screening, should be
evaluated for latent M. tuberculosis infection (LTBI). LTBI evaluated should consist of either a
tuberculin skin test (TST) or interferon-gamma release assay (IGRA). Orphans with a negative
test for TB infection should have LTBI testing repeated 6 months after arrival.
Receipt of bacille Calmette-Guérin (BCG) vaccine is not a contraindication to a TST, and a
positive TST result should not be attributed to BCG vaccine. A patient with a known positive
TST should not have the skin test repeated as it may provoke a local reaction.
Elements of the medical history for TB should include;
Previous history of TB
Illness suggestive of TB (such as cough of >3 weeks duration, dyspnea, weight loss, fever, or
Prior treatment suggestive of TB treatment (especially if incomplete of discontinued)
Prior diagnostic evaluation suggestive of TB
Children are less likely than adults to present with “classic” signs and symptoms of TB such as
night sweats, hemoptysis or cavitary findings on chest x-ray. Children more frequently present
with generalized findings such as fever, growth delay, and weight loss. Children are also more
prone to extra-pulmonary TB, such as meningitis, and disease of the middle ear and mastoid,
lymph nodes, bones, joints, and skin. Clinical symptoms can be subtle. The clinician should
keep in mind that TB can present with virtually any sign or symptom and should be included in
the differential diagnosis of most abnormal clinical findings.
Pertinent elements of the physical exam specific for TB include;
Thorough pulmonary examination
Inspection and palpation of appropriate
Inspection for scars of scrofula, and
prior chest surgery
VACCINE PREVENTABLE DISEASES
Vaccine preventable diseases (VPD) are another important public health consideration for this
population. Haiti provides BCG, diphtheria, pertussis (whooping cough) and tetanus (DTwP);
5 measles rubella (MR); oral poliovirus (OPV); and tetanus and diphtheria toxoids (Td), as part of
its routine immunization schedule (along with Vitamin A). However, vaccination coverage rates
are low for most of these vaccines. For example in 2008, coverage for measles vaccination was
58%, third dose DTP 53%, and third dose polio 52%. Moreover, Haiti does not provide a 2nd
measles dose, hepatitis A, hepatitis B, Haemophilus influenzae type b (Hib), rubella, varicella,
rotavirus, meningococcal, or pneumococcal vaccinations which are considered routine childhood
immunizations in the U.S.
Children and adolescents adopted from Haiti should receive immunizations according to the
recommended schedule in the United States for healthy children and adolescents (see:
In general, when data are available for the orphans in a country, written documentation of
immunizations (if available) can be accepted as evidence of adequacy of previous immunization
if the vaccines, dates of administration, number of doses, intervals between doses, and age of the
child at the time of immunization, are consistent internally and comparable to current US or
World Health Organization schedules (http://elib2.cdc.gov:2801/cgi/content/full/2009/1/1.5.13).
However, given the limited data available regarding verification of immunization records in
Haitian orphans, and the known low vaccine coverage rates in Haiti, it may be preferred to reimmunize
the child presumptively. It is also acceptable to perform serologic evaluation of
concentrations of antibodies to vaccines for certain antigens (i.e. measles, mumps, rubella,
hepatitis A, polio, tetanus and diphtheria) (CDC. General Recommendations on Immunization.
MMWR 2006;55 (No. RR-15):). Because the rate of more serious local reactions after
diphtheria, tetanus, and pertussis (DTaP) vaccine increases with the number of doses
administered, serologic testing for antibody to tetanus and diphtheria toxins before reimmunizing
(or if a serious reaction occurs) can be considered if appropriate immunization is in
Serologic testing for the surface antigen of the hepatitis B virus (HBsAg) should be performed
on all children to identify chronic infection. If serologic testing is not available and receipt of
immunogenic vaccines cannot be ensured, the prudent course is to provide the immunization
Ideally, adoptive parents, family members and other close personal contacts should ensure they
are immunized or otherwise immune to hepatitis A virus infection before international travel to
pick up the child. If this is not feasible, serologic testing of the orphan for hepatitis A IgM and
IgG is recommended, to identify current/recent or past infection. If a child has no evidence of
previous infection, the child should be immunized against hepatitis A according to the
recommended immunization schedule. If IgG tests positive, indicating past infection, no
immunization will be required for the child. If IgM is positive, indicating current/recent
infection, all close contacts and family members should be immunized. Orphans or their
household or other close contacts with symptoms consistent with acute viral hepatitis should be
Screening for HIV should be performed on all orphans from Haiti. Transplacentally acquired
maternal antibody in the absence of infection can be detected in a child younger than 18 months
of age. Hence, positive HIV antibody test results in asymptomatic children of this age require
clinical evaluation, further testing (follow-up serologic and PCR), and counseling.
In a nationwide survey on intestinal helminths in 5792 urban and rural school children conducted
in Haiti in 2002, 34% of stools tested positive for intestinal helminths with the following
parasites identified: Ascaris lumbricoides (27.3%), Trichuris trichiura (7.3%), Necator
americanus (3.8%), Hymenolepsis nana (2%), Taenia sp. (0.3%) and Strongyloides stercoralis
(0.2%) (Champetier de Ribes et al, Bull Soc Pathol Exot. 2005 Jun; 98(2):127-32).
Most experts would perform three stools for ova and parasite (O&P) testing collected on three
consecutive mornings on all children, regardless of symptoms. If stool O & P examinations are
negative and the child has eosinophilia (absolute eosinophil count exceeding 450 cells/mm3),
then strongyloides species serologic testing is recommended as stool O&P have poor sensitivity
for this infection and the disease can be chronic and lead to serious morbidity (Red Book®: 2009
Report of the Committee on Infectious Diseases – 28th Ed. 2009).
If gastrointestinal tract signs or symptoms are present, send stool specimens for culture, and stool
antigen testing for giardia, cryptosporidia, and rotavirus.
Over 99% of the malaria parasite species that causes malaria in Haiti is P. falciparum, where it is
endemic. It has been reported that up to 75% of the population of Haiti lives in malarious areas,
especially at altitudes <300 m above sea level (Garcia-Martin, Am J Trop Med Hyg. 1972;
21:617–33). Therefore, it is recommended to screen symptomatic orphans for malaria with a
malaria smear. Treatment guidelines can be found on the CDC website
Clinicians should screen each orphan for syphilis by reliable nontreponemal and treponemal
serologic tests. Children with positive treponemal serologic test results should be evaluated by
someone with special expertise to assess the differential diagnosis of pinta, yaws, and syphilis
and to determine extent of infection so appropriate treatment can be administered.
Because of stigma in Haitian culture around mental illness, many children may be reluctant to
discuss or admit to mental health problems. Likewise, prior caregivers in Haiti may not have
fully explored such issues, even prior to the earthquake. The experience of the January 2010
Haitian earthquake would be expected to impact greatly on many of the orphans exposed.
Clinicians should consider potential mental health and developmental issues. When mental
health referrals are warranted, added care should be made to explain and arrange such referrals to
the patient and his/her caregivers in a culturally sensitive, supportive, and non-stigmatizing way.
This document presents recommendations for an immediate medical screening of Haitian
orphans entering the US under humanitarian parole status. This is not a comprehensive
examination, and it is strongly recommended to have a comprehensive medical history and
physical examination once they arrive at their final destination to evaluate other medical and
developmental issues in the child, including hearing and vision assessment, evaluation of growth
and development, blood lead concentration, complete blood cell count with red blood cell
indices, newborn screening and/or measurement of thyroid-stimulating hormone concentration,
and examination for congenital anomalies (including fetal alcohol syndrome). (Red Book®: 2009
Report of the Committee on Infectious Diseases – 28th Ed. 2009).
Office of Communications
Questions and Answers February 4, 2010
Information for U.S. Citizens in the Process of Adopting a Child from Haiti
On Jan. 12, 2010, Haiti experienced an earthquake of devastating proportions. This set of questions and answers provides information for United States citizens that have adopted a child or are in the process of adopting a child from Haiti prior to Jan. 12, 2010.
Questions and Answers
Q. I am in the process of adopting a child from Haiti, what can I do to bring the child to the United States?
A. Department of Homeland Security (DHS) Secretary Janet Napolitano has authorized the use of humanitarian parole for the following categories of orphans in Haiti:
Category 1 Cases Description: Children being adopted by U.S. citizens prior to Jan. 12, 2010, who have been legally confirmed as orphans available for inter-country adoption by the Government of Haiti (GOH) through an adoption decree or custody grant to suitable U.S. citizen adoptive parents.
Evidence of availability for adoption MUST include at least one of the following:
Full and final Haitian adoption decree; or
GOH custody grant to prospective adoptive parents for emigration and adoption; or
Secondary evidence in place of the above.
Evidence of suitability MUST include one of the following:
Approved Form I-600A, Application for Advance Processing of an Orphan Petition; or
Current FBI fingerprints and security background check; or
Physical custody in Haiti plus a security background check.
Please note, some of the children in this category will receive immigrant visas and others will receive humanitarian parole, depending on the completeness of the cases. Those who enter with immigrant visas will enter as aliens lawfully admitted for permanent residence. Those who enter with humanitarian parole will need to have their immigration status finalized after arrival through an application for adjustment of status.
Category 2 Cases Description: Children who have been identified by an adoption service provider or facilitator as eligible for intercountry adoption, were matched to prospective American adoptive parents prior to Jan. 12, 2010 and meet the below criteria.
Significant evidence of a relationship between the prospective adoptive parents and the child; AND of the parents’ intention to complete the adoption, which could include the following:
Proof of travel by the prospective adoptive parents to Haiti to visit the child;
Photos of the child and prospective adoptive parents together;
An Adoption Service Provider (ASP) “Acceptance of Referral” letter signed by the prospective adoptive parents;
Documentary evidence that the prospective adoptive parents initiated the adoption process prior to Jan. 12, 2010, with intent to adopt the child (filed Form I-600A, Application for Advance Processing of an Orphan Petition, and/or Form I-600, Petition to Classify an Orphan as an Immediate Relative, completed a home study, located an ASP to work with in Haiti, etc.).
Evidence of the child’s availability for adoption, which would include the following:
IBESR (Haitian Adoption Authority) approval;
Documentation of legal relinquishment or award of custody to the Haitian orphanage;
Secondary evidence in place of the above.
Evidence of suitability MUST include one of the following:
Approved Form I-600A, Application for Advance Processing of an Orphan Petition; or
Current FBI fingerprints and security background check.
If the child you have adopted or are adopting meets these criteria, please send U.S. Citizenship and Immigration Services (USCIS) detailed information about the adoption case at HaitianAdoptions@dhs.gov. This e-mail address is dedicated to collecting information about adoption cases still pending in Haiti. Please include the name of the prospective adoptive parent in the subject line of the e-mail. Once we have your information, we will contact you with further information.
Q. How do I request Humanitarian Parole for the child I am in the process of adopting?
A. If you want to request humanitarian parole for a specific child you are in the process of adopting from Haiti, please send the request to HaitianAdoptions@dhs.gov. Please include the name of the prospective adoptive parent in the subject line of the e-mail. You do not need to file Form I-131 or submit a fee for these cases.
Q. If parole is authorized, how will my child get out of Haiti?
A. The Department of State and Department of Homeland Security are coordinating the transport of Haitian orphans with approved travel documents to ensure their safe arrival into the U.S. Currently, children are traveling by both military and private aircraft. We urge families not to make individual arrangements and to assist us in coordinating with the orphanages on the ground. To obtain more information on the process for scheduling appointments for Orphan Screening at the U.S. Embassy in Port-au-Prince, please see the Q&A below on scheduling.
Orphanage directors should first schedule an appointment before taking their group of children to the Embassy for processing. Individuals or groups that appear at the Embassy without prior coordination may be turned away.
Q. If humanitarian parole is authorized, may I travel to pick up a specific child?
A. The Department of State (DOS) Travel Warning urges U.S. citizens to avoid travel to Haiti. Communications and transportation in Haiti are extremely limited and nearly all available resources are dedicated to the immediate search and rescue of Haitians. Updates to the DOS travel warnings for Haiti are available online at http://www.travel.state.gov/travel/cis_pa_tw/tw/tw_4632.html
Once a child receives a visa or is authorized for humanitarian parole, we encourage you to work with your U.S. adoption agency and the orphanage staff in Haiti to identify an escort to bring the child to the United States.
Should you intend to travel to Haiti, USCIS strongly urges you to contact USCIS through Haitianadoptions@dhs.gov before traveling to ensure that all the paperwork necessary for your child to be paroled into the U.S. has been completed and that, if you have not been fingerprinted, you are fingerprinted in the U.S. Getting fingerprinted in Haiti may delay the processing of your case.
Q. Many documents were destroyed in the earthquake. What kind of secondary evidence can be submitted in the place of primary documents?
A. Secondary evidence may include, but is not limited to, copies of records or correspondence referring to the existence of the destroyed or missing document, as maintained by an Adoption Service Provider or the prospective adoptive family, as well as affidavits of individuals with knowledge of the document or event.
Q. I am a prospective adoptive parent in the process of adopting a child in Haiti, but the adoption was not finalized prior to the earthquake. If DHS authorizes humanitarian parole for a child who was not legally adopted in Haiti, how will I obtain the legal authority to take the child into my home?
A. If you received an order from the Government of Haiti granting custody of the child to you, then the child may be paroled into your custody upon verification of the order, your identity and that of the child after the child’s arrival in the United States.
If you have not received a formal order granting you custody from the Government of Haiti, then the child may be placed in your care but some additional procedures must be followed first. These procedures are intended to protect children and ensure that those without final adoptions are placed with families that are able to care for them. These additional procedures may take a little time, but they are critical for keeping children safe. Children who cannot be placed with prospective adoptive parents will be well cared for. The Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS) has contracts with organizations around the country to care for unaccompanied children who are not U.S. citizens. For more information on this process, please review the information for adoptive parents available on the U.S. Dept. of Health and Human Services website at http://www.hhs.gov/haiti/adoptionrelease.html
Whether you become a sponsor or not, you will need to adopt the child under the adoption laws of your place of residence in order for the child to acquire permanent residence in the United States. More information regarding the process for finalizing the adoption in the U.S. will be provided on the USCIS website once available. If your child is over the age of 14, please contact us immediately by forwarding
an email to HaitianAdoptions@dhs.gov. To ensure that your request is processed correctly, please follow the instructions below: 1. In the subject line of your email type: “Child in U.S. – Over age 14”
2. In the body of the e-mail be sure to include:
Your full name
Your home address
Your child’s name
Your child’s date of birth
Information about how to best contact you
Q. I am a prospective adoptive parent in the process of adopting a child from Haiti. What should I do if my Fingerprint Clearance has expired?
A. USCIS will review each prospective adoptive parent’s request for humanitarian parole on a case-by-case basis. If we determine that your fingerprint clearance(s) has expired, you do not need to take any action. USCIS will electronically rerun your prints. (Please do not send a request for updated fingerprint to HaitianAdoptions@dhs.gov.) If you have not been fingerprinted by USCIS at any stage of your adoption process, please send an e-mail message to HaitianAdoptions@dhs.gov and we will arrange a fingerprint appointment for you. Please include “FP Request” in the subject line of the e-mail.
Q. Is there any other way I can help orphans in Haiti?
A. We understand that some Americans want to respond by offering to open their homes. We certainly appreciate this generous impulse, but note that it can be extremely difficult to determine whether children are truly orphans. Children may be temporarily separated from their parents or other family members, and their parents or other relatives may be looking for them. In the first instance, we believe it is most important to focus on re-uniting separated children with their relatives. Some individuals may wish to assist by contributing to a reputable relief or humanitarian organization working in that country. More information can be found at the following Web sites:
Department of State – http://www.state.gov or http://www.state.gov/p/wha/ci/ha/earthquake/index.htm
United States Agency for International Development (USAID) – http://www.usaid.gov
International Committee of the Red Cross (ICRC) – http://www.icrc.org
Interaction – http://www.interaction.org
Q. I have heard the Government of Haiti has stopped allowing orphans to leave Haiti. What will happen to my child if I am still in the process of adoption?
A. The United States government is working closely with the Government of Haiti to establish an efficient and transparent procedure to allow eligible children to depart quickly while also ensuring the best possible protection of unaccompanied and separated children.
The government of Haiti has not stopped allowing orphans to leave Haiti. USCIS is continuing to process cases that meet the DHS Secretary’s criteria for category 1 and 2, however we are unable to issue travel letters for each child to depart until we receive approval from the Government of Haiti (GOH). Once approval is received, we are able to issue travel documents to authorized children.
Q. Once the children in an orphanage have been screened, and evaluated, should the orphanage director bring the children to the U.S. Embassy?
A. We recommend against attempting to enter the U.S. Embassy, particularly with a group of children, without first scheduling an appointment in advance. There is a possibility that you may be turned away and scheduled to come back another day.
USCIS is proactively scheduling appointments at the U.S. Embassy in Port-au-Prince to screen Haitian children who were adopted or were in the process of being adopted by U.S. citizens prior to the January 12 earthquake. Whenever possible, we will schedule all children from the same orphanage/facility, at the same time.
To obtain more information on the process, please review the How to Schedule an Appointment for an Orphan Screening at the U.S. Embassy in Port au Prince fact sheet at http://www.uscis.gov/haitianearthquake.
Q. What are the medical screening requirements for adopted children from Haiti?
A. Before internationally adopted children come to the United States, they are usually required to go through a medical exam. However, due to the lack of available medical screening facilities and the burden of emergent medical needs in Haiti as a result of the January 12 earthquake, we anticipate that many children arriving as humanitarian parolees will not have completed their medical exams before they depart Haiti. Medical examinations are not required as a part of the humanitarian parole program.
As a result, it is important that all arriving adoptive children from Haiti undergo a medical screening process soon after arrival to screen for infectious diseases and other general health concerns. Additional guidance regarding medical exams for adopted children from Haiti is available from the Department of Heath and Human Services, Centers for Prevention and Disease Control Web site at http://www.cdc.gov/immigrantrefugeehealth/exams/parents-adopting-children-haiti-earthquake.html
Q. If my child is traveling from Haiti, are there any specific provisions I should know when he or she arrives in the United States?
A. Please note that a U.S. Customs and Border Protection (CBP) officer must inspect all individuals traveling to the United States when they arrive at a port of entry. For more information on the process for obtaining the legal authority to take into your home your child or the child you are in the process of adopting, please review the questions above or view the information for adoptive parents available on the U.S. Dept. of Health and Human Services (HHS) website at http://www.hhs.gov/haiti/adoptionrelease.html.
Q. I submitted the original adoption decree and other documents to the USCIS field office in Port-au-Prince. How do I get these documents back after my child arrives in the United States?
A. To request the return of original documents submitted to establish eligibility for an immigration benefit, please fill out Form G-884, “Return of Original Documents,” which is available to download from the forms section on USCIS’ Web, http://www.uscis.gov/forms.