Form I-693 Medical Exam and Vaccination Immigration Report Guide

One crucial step in obtaining a green card is proving you meet the U.S. health requirements. The Medical Examination and Vaccination Record Report (the I-693 Form) comes into play here. This form documents your immigration medical exam and vaccination history, assuring USCIS you won’t pose a public health threat.

Our I693 USCIS form guide will help you understand Form I-693 and everything it involves. We’ll discuss its purpose, walk you through the completion process, and explain how it fits into the bigger picture of your green card application. By understanding this essential form, you’ll be able to complete your journey to permanent residency with no hassle.

Let’s begin!

What Is Form I-693 for the Green Card Health Exam?

Imagine Form I-693 as a health report card for your immigration application. It documents the results of a particular medical exam conducted by a doctor authorized by USCIS. This medical examination for the green card helps USCIS ensure that you don’t have any health conditions that could pose a public health risk to the United States (more on that later).

Why Do I Need Form I-693?

Most green card applicants submitting Form I-485 to adjust their status from within the U.S. must complete Form I-693. It’s USCIS’s way of ensuring you meet specific health requirements to become a permanent resident.

Who Conducts This Medical Exam for Immigration and Green Cards?

A doctor will conduct the medical exam for Form I-693. They are called “civil surgeons” and are approved by USCIS. During the USCIS medical exam, the doctor will see your medical history, perform a physical examination, and ensure you’ve received all the required vaccinations.

What Happens After the I-693 USCIS Medical Exam?

Once the doctor completes the exam, they’ll complete Form I-693 with your results. They’ll then seal the form in an envelope and give it to you to submit to USCIS and your green card application.

IN SUMMARY: If you’re applying for a green card from within the U.S., you’ll likely need to undergo a medical exam by a USCIS-authorized doctor (civil surgeon). This doctor will complete Form I-693, documenting your exam results and vaccination history. Once sealed by the doctor, you’ll file this form together with your green card application (Form I-485) to USCIS.

Do you need more clarification about the green card medical exam requested by USCIS and the I-693 form? Let’s move on to the next section of this guide: the purpose of the USCIS I-693 immigration medical exam.

What Is the Purpose of the USCIS-mandated Immigration Physical Exam?

This seemingly simple form plays a crucial role in your green card application by serving two essential purposes: protecting public health and ensuring your admissibility to the United States.

Protecting Public Health

The United States prioritizes the health and safety of its citizens. Form I-693 plays a part in this by helping identify potential health risks among green card applicants. During your medical exam, a USCIS-authorized doctor will assess your overall health and check for any infectious diseases that could threaten the public health:

  • Tuberculosis (TB): A severe bacterial infection that affects the lungs. 
  • Syphilis: Severe STD that can cause long-term health problems if left untreated.
  • Gonorrhea: Another STD that can lead to complications if not treated promptly.

Meeting the Criteria for Admissibility

Beyond public health, Form I-693 is also vital to determining whether you meet the criteria for entering the United States. Immigration laws outline specific medical conditions or diseases that can make someone inadmissible, like certain infectious diseases, mental or physical disorders that could be a safety concern or substance abuse issues.

As mentioned earlier, certain infectious diseases can be grounds for inadmissibility. The Department of Health and Human Services identifies specific diseases as significant public health threats:

  • Gonorrhea
  • Hansen’s Disease (Leprosy): A chronic infectious disease that can damage nerves and skin. It’s important to note that with early treatment, Hansen’s Disease is no longer considered highly contagious.
  • Syphilis
  • Tuberculosis, with the amendment that only active TB diagnoses are typically grounds for inadmissibility.

As far as mental or physical health disorders are concerned, the category includes conditions that could pose a danger to yourself or others, such as severe mental illness or conditions that significantly impair your ability to care for yourself.

Drug or alcohol addiction is also a reason for inadmissibility. USCIS will consider the severity of the addiction and its potential impact on your health and safety.

In addition to these specific diseases, a lack of vaccinations for preventable diseases can also raise inadmissibility concerns. The CDC maintains a recommended immunization schedule for adults entering the United States.

IMPORTANT! As of October 1, 2021, if you must file Form I-693 you also must get a COVID-19 vaccine and bring vaccination proof to your appointment with the civil surgeon!

Basically, the situation is this: through your medical exam and completing Form I-693, you demonstrate that you don’t have any of these conditions that would prevent you from being admitted to the United States. The exam also verifies that you’ve received the vaccinations required by the CDC (COVID-19 vaccines included), further contributing to public health protection.

In short, Form I-693 is vital in ensuring a painless green card application process by protecting public health and verifying your eligibility to enter the United States. And speaking about eligibility…

Who Needs to Complete Form I-693: Understanding the Green Card Medical Exam Requirement

Most green card applicants seeking adjustment of status from within the U.S. must complete Form I-693. This applies to individuals applying under various categories, such as family-based sponsorship, employment sponsorship, or special immigrant programs.

Here are some of the most common scenarios where USCIS requires Form I-693:

Category Description

Those who want a green card through family sponsorship, employment sponsorship, or other special immigrant programs need Form I-693.

Refugees adjusting status

Refugees who have been in the U.S. for one year and are applying for a green card must complete Form I-693, even if they have had a medical exam before arrival.

K Visa and V Visa holders adjusting status

If you hold a K visa (fiancé(e) of a U.S. citizen or a V visa (spouse or child of a green card holder) and are adjusting to permanent residency, you'll need Form I-693.

Certain nonimmigrant visa holders (upon request)
In some cases, USCIS may request Form I-693 from nonimmigrant visa holders seeking a status change or an extension of stay.

Who Can Skip Form I-693?

There are some exceptions to the requirement for Form I-693. Generally, you don’t need to complete the form if you’re already a green card holder and are only applying to remove conditions on your existing green card (through form I-751).

Now that you understand the purpose of this USCIS medical examination for green card seekers let’s discuss Form I693 in more detail so you can prepare for the application.

What Edition of the I-693 Does Your Doctor Need to Complete?

Your civil surgeon needs to know this, but it doesn’t hurt to check to ensure you have the proper paperwork. Why? Because USCIS periodically updates Form I-693. 

Your doctor must use the current form edition, as USCIS may reject your application if you submit an outdated version.

The edition date for Form I-693 is at the bottom of each page, including the form itself and the instructions. As you read this guide, know that the current edition date is March 9, 2023 (03/09/23). By taking a few moments to confirm you’re using the current edition of Form I-693, you can help avoid unnecessary delays or rejections in your green card application process.

When Should I Submit the I-693 Form, and What Is Its Validity?

Most people know that the validity of Form I-693 is two years, counting from the date the civil surgeon signed it. 

However, things have changed.

USCIS now says Form I-693 doesn’t expire anymore if it was filled out and signed by a certified civil surgeon on or after November 1, 2023. You can use the same form for future applications if it shows you meet the health requirements. So, if you start the I-693 application process today, the form will be valid indefinitely!

As for when to file Form I-693, USCIS recommends submitting the medical report with your initial Form I-485 application (to adjust status) whenever possible.

While you technically have the flexibility to wait, filing both forms together offers several advantages:

  • Reduced processing time, as it can help USCIS avoid issuing a Request for Evidence specifically for your medical exam, potentially speeding up your application review.
  • Interview waiver potential: If your case meets certain criteria, filing both forms together might eliminate the need for an interview altogether.

Ultimately, the decision of when to submit Form I-693 is yours. However, USCIS encourages including it with your initial I-485 application to potentially streamline the processing timeline.

I-693 Green Card Medical Exam: A Step-by-step Guide

We’ve created a step-by-step guide, so you understand the I693 submission process and ensure everything goes effortlessly. This section covers everything from finding the right doctor to submitting your form correctly.

Step 1: Gather the Required Documents for Your I-693 Medical Exam

A successful immigration medical exam requires having the correct documents. However, the exact list can vary depending on the location of your exam and any specific requirements from the U.S. embassy (if you’re applying from outside the U.S.).

Here’s our advice: contact the civil surgeon’s office directly before scheduling your appointment. They can provide the most up-to-date documents needed for your specific situation. 

Nevertheless, let’s see some of the most common documents most civil surgeons request for the I-693 medical exam and vaccination report:

I-693 Medical Exam Required Documents Explanation

Government-issued photo ID (passport or driver's license)

It verifies your identity.

Vaccination records (if available)

Proof of your current immunizations helps meet USCIS's health requirements.

*COVID-19 vaccination proof: show documentation of a completed vaccine series (2 doses of Moderna vaccine, OR 2 doses of Pfizer vaccine, OR 1 dose of Johnson & Johnson vaccine).

Form I-693

** (Bring a copy)**

This is the form completed by the doctor after your exam. You can download the I-639 form PDF from the USCIS website.

Medical records (if applicable)

Bring relevant documentation for the doctor's review if you have any pre-existing medical conditions.

* Past positive TB skin test: bring a tuberculosis certificate from your doctor proving proper treatment.

 * History of syphilis: doctor or public health official's signature on a certificate stating you were treated correctly. 

* Record of violent behavior: a doctor's assessment of whether it was caused by a medical condition or substance abuse. 

* Past mental illness/addiction: written certification with diagnosis, treatment duration, and prognosis.

Certified translations (if applicable)
If any documents are not in English, have them translated by a certified service to ensure clear communication with the civil surgeon.

Step 2: Find a USCIS-approved Civil Surgeon to Ensure a Valid I-693 Form

To ensure your form is valid, a USCIS-approved civil surgeon must complete your immigration physical exam. 

Here’s how to find a civil surgeon in your area:

Head to the USCIS website, as it’s the official source of information. Use the “Find a Civil Surgeon” page, designed specifically for immigration medical exams.

Next, use the search bar to enter your zip code, city, or state and hit “Search.” It will show you a list of approved civil surgeons nearby. The list will also provide details like names, addresses, and phone numbers. Take your time to choose the doctor that best suits your needs.

If you found the right doctor, contact the chosen surgeon’s office to book an appointment. Remember, these appointments can fill up fast, so plan to avoid delays in your application process.

Don’t forget to ask about the costs! The medical exam price depends on the doctor’s fees and any additional tests or vaccinations needed. Be sure to inquire about the cost upfront to avoid any surprises and ensure you’re financially prepared.

Step 3: Submit the I-693 Medical Report to USCIS

If you apply for a green card in the U.S., after the medical examination (there may be more than one), the civil surgeon will provide your completed Form I-693 in a sealed envelope. Do not accept the envelope if it’s not sealed! USCIS will return the form to you if the seal is broken or tampered with in any way.

IMPORTANT! USCIS requires that you, the applicant, submit Form I-693, not the civil surgeon!

If you’re applying for a green card through adjustment of status, you have a few options for submitting your Form I-693:

  • Together with Form I-485: Include your completed Form I-693 and your green card application when you mail it. If you don’t know where to mail it, check this USCIS page for addresses and information!
  • Mail it separately (if you already filed I-485): If you’ve already submitted your adjustment of status petition, you can mail Form I-693 separately to the address provided in your most recent communication from USCIS (such as a request for evidence letter/Notice of Action).
  • In-person (if required): If USCIS requires an interview for your green card application, you may be able to bring your sealed Form I-693 to the interview and submit it then.

If you’re not applying for adjustment of status, follow the specific instructions provided within your application package or as directed by the office requesting your medical exam.

If this medical exam for immigration takes place in your home country (as you haven’t come to the United States yet), the doctor (panel physician) will give you a sealed envelope containing your results and an X-ray (if needed). You must bring this sealed envelope to your immigration interview at your home country’s U.S. embassy or consulate.

IMPORTANT! Sign Form I-693 before submitting it! USCIS requires your signature to verify your identity and confirm your acknowledgment of the information on the form. An unsigned I-693 will be considered incomplete and could lead to your application’s delay or rejection. So, please take a moment to review the completed form carefully and then sign it before submitting it with the rest of your immigration paperwork!

Form I-693 Processing Time and Timeline

While Form I-693 is often filed with Form I-485, the processing times for I-485 itself can vary significantly. These processing times can range anywhere from 1 year to 3 years, depending on your circumstances.

To avoid any delays in your application process, it’s important to schedule your immigration medical exam as close as possible to a critical event:

  • Filing for status adjustment when you submit Form I-485.
  • Responding to an RFE: If USCIS asks for your medical exam results, scheduling your exam close to the RFE response will ensure your results are valid.
  • Your interview (if required): Having a recent exam on file helps avoid needing additional medical checks before your interview.

IMPORTANT! Remember to factor in lab tests! Some exams may require additional testing by a lab. Make sure to schedule your exam early enough to allow sufficient time for any necessary tests to be completed and the results returned to the doctor.

How Much Does the I-693 Exam Cost? USCIS Medical Examination Report Fees

While there’s no fee to file Form I-693 itself, you’ll need to pay for the medical examination performed by the civil surgeon. The USCIS medical exam fee depends on your location and the civil surgeon’s prices.

Generally, expect to pay between $150 and $600, with an average cost of around $250-$300. 

It’s a good idea to call the civil surgeon’s office in advance to get a specific quote. This way, you can be financially prepared for your appointment.

The typical cost of a medical exam for Form I-693 encompasses several components: the doctor’s fee for conducting the physical exam and reviewing your medical history, laboratory tests like blood work and tuberculosis screening (which are standard and add to the overall cost), and any vaccinations you might need if your immunization records are incomplete (these vaccinations come with additional charges).

Here are some tips to help you manage the costs of your Form I-693 medical exam:

  • Since designated civil surgeons set their own rates, it’s wise to call a few in your area and inquire about their fees to compare costs and choose a doctor that fits your budget and availability.
  • Think about your immunization history and any known medical conditions. If you anticipate additional tests or vaccinations, discuss this with the civil surgeon’s office during scheduling to get a more accurate quote.
  • Most civil surgeons require payment upfront during your appointment. Confirm accepted payment methods (cash, credit card, etc.) when scheduling to avoid surprises.
  • While uncommon, some health insurance plans may cover some medical exam and vaccination costs. Check with your provider to see if any portion of the exam might be covered under your plan.

Researching civil surgeon fees, understanding potential additional I-693 costs, and considering insurance coverage allow you to plan accordingly for getting a valid, complete, and affordable USCIS medical examination report, so don’t neglect this budgetary aspect!

Form I-693 Medical Exam Immigration Report Frequently Asked Questions

Whether you have questions about what the I-693 medical exam entails, its costs, vaccinations, or required documents, our FAQs provide more concise answers.

Is gonorrhea testing mandatory for the I-693 USCIS medical examination?

While most green card applicants over 15 need a gonorrhea test, some exceptions exist. If you fall into any of these categories, you might be able to skip the full medical exam and just submit a completed vaccination record along with the standard Form I-693:

  • Refugees
  • Derivative asylees applying within a year of eligibility
  • K and V nonimmigrants applying within a year of their overseas medical exam (provided it didn’t find a serious health condition)

The table below offers a quick reference for those who need a gonorrhea test and a complete I693 exam.

Applicant's Age Needs Gonorrhea Test? Needs Full Medical Exam?
15 years or older
Yes (unless exempt)
Younger than 15 years old
Only if suspected infection
No (unless suspected infection)
Exempt Applicants (Any Age)

Obtaining a green card requires meeting specific vaccination standards set by the CDC. The designated civil surgeon will review your records and administer any missing vaccines during your medical exam. Here’s a breakdown of the most common vaccinations required:

Vaccine Age Requirement Details
Measles, Mumps, Rubella (MMR)
All applicants
Typically two doses: 1st dose after 1st birthday, 2nd dose at least 28 days later
Varies by age & history
Depending on age and vaccination history, an inactivated polio vaccine (IPV) or oral polio vaccine (OPV) is required.
Tetanus & Diphtheria Toxoids
All applicants
Primary series + booster dose within the last 10 years
Pertussis (Tdap)
Never received pertussis vaccine
Single dose required
Hib (Haemophilus influenza type B)
Under age 5
The number of doses depends on when the vaccination series began
Hepatitis A
12 months to 18 years
Single dose required
Hepatitis B
All applicants
The number of doses depends on when the vaccination series began
6 to 32 weeks old
Single dose required for infants
Meningococcal Disease
2 months to 55 years
Age-specific recommendations
Varicella (Chickenpox)
No prior immunity
One or two doses, depending on the age
Pneumococcal Disease
Under age 2 and adults 65+
Age & risk factor-specific recommendations
Seasonal Influenza
6 months & older (flu season)
Typically required from October through March

IMPORTANT! The specific vaccination requirements can vary depending on your age and medical history. These requirements are also subject to change, so check the CDC website for up-to-date information. When scheduling your I-693 medical exam, follow the recommendations provided by the designated civil surgeon to ensure you meet all necessary vaccination requirements!

Suppose you recently entered the U.S. with a K visa (fiancé(e) or child) or a V visa (spouse or child), and you had a medical exam as part of the visa application process. In that case, you might be exempt from another exam when applying for a green card! This applies to:

  • K-1 Fiancé(e)s
  • K-3 Spouses
  • K-2 Children of K-1 Fiancé(e)s
  • K-4 Children of K-3 Spouses
  • V-1 Spouses
  • V-2 Children of V-1 Spouses
  • V-3 Children of Unmarried V-2 Holders

Here’s the catch: to skip the exam, you must file Form I-485 within one year of your original medical exam.

Even if you don’t need another exam, you must prove you meet all U.S. vaccination requirements. If your records show you’re missing any vaccines, you must see a designated civil surgeon to get caught up.

Do You Need Help Getting a Valid and Error-free I-693 Form for Green Card Purposes? We Can Help!

Our experienced ImmigrationDirect experts are here to guide you every step of the way. We can help you understand the USCIS immigration medical exam requirements, ensure your vaccination records are complete, and answer any questions about filing Form I-693, including costs, deadlines, and where to submit the form. We can also help you with filing Form I-485 and deal with the entire green card process from start to finish seamlessly. Don’t go through this alone! Get in touch today for a consultation, and let us help you achieve your immigration goals!

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