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Back arrow to return to all resources page All resources Medical Exceptions for U.S. Citizenship Test

  • Immigration
  • Form
The U.S. citizenship test contains English and civics portions that applicants must regularly complete. The test requires demonstration of proficiency in the English language, including reading, writing, and speaking abilities. Additionally, applicants must demonstrate understanding of the history, forms of government, and principles of the U.S. For individuals who are differently-abled or who are living with a mental health condition, demonstrating proficiency in these concepts can be challenging, yet this should never preclude someone from obtaining U.S. citizenship.
This form, titled Form N-648, can be filled out by medical providers on behalf of immigrant patients who are applying for citizenship yet are unable to complete the English and/or civics portions of the U.S. citizenship test. Detailed instructions to fill out Form N-648 can be found here.
Additional Information: The Providence Community Library offers free citizenship test preparation classes on Mondays from 6-7:30 pm over 10 weeks, beginning January 11th. The classes are taught in English, but the instructor speaks Spanish as well. People interested in participating should email Carolina Briones at


  1. Form N-648: Medical Certification Form

Next steps

The completed form should be given to the patient who is applying for citizenship in order to submit along with the completed N-400, Application for Naturalization.