An immigration medical examination is an important step for many people applying to become lawful permanent residents of the United States. As part of the process, U.S. Citizenship and Immigration Services (USCIS) may require applicants to submit Form I-693, Report of Immigration Medical Examination and Vaccination Record. This form documents the results of a medical examination conducted by an authorized physician and records relevant vaccination information.
Applicants preparing for adjustment of status may have questions about who must complete the examination, where to schedule it, what documents to bring, and how to submit the completed form. Understanding these requirements can help applicants avoid preventable filing problems. The process also requires attention to current USCIS instructions because medical examination procedures and validity policies can change.
This guide explains the purpose of Form I-693, how to prepare for an immigration medical examination, which records may be useful, how the sealed envelope works, and what applicants should understand about the form’s validity. It is general educational information, not a determination of eligibility for any individual immigration benefit.
What Is Form I-693?
Form I-693 is the Report of Immigration Medical Examination and Vaccination Record. USCIS uses it to assess whether an applicant meets applicable health-related requirements for an immigration benefit, particularly adjustment of status to lawful permanent residence when a medical examination is required.
The examination is conducted by a physician designated by USCIS as a civil surgeon, subject to limited exceptions under applicable rules. The civil surgeon reviews the applicant’s medical history, performs the required examination, arranges any required testing, and evaluates vaccination documentation. The physician then completes the applicable portions of Form I-693.
The medical examination is not a general immigration interview, and it does not determine every aspect of an applicant’s eligibility. USCIS considers the medical report together with the application and other evidence when making an immigration decision.
Who Needs an Immigration Medical Examination?
Many applicants seeking adjustment of status to permanent residence must complete an immigration medical examination. However, the requirement depends on the immigration category, the applicant’s circumstances, and applicable USCIS rules. Some applicants may have completed an examination overseas or may fall within a specific exception or alternative procedure.
Applicants should review the current instructions for their particular immigration application rather than assuming that every person seeking a green card follows the same process. The instructions for Form I-485, Application to Register Permanent Residence or Adjust Status, explain the documentation required for the relevant filing category.
For many applicants filing Form I-485, USCIS requires the applicable Form I-693 to be submitted with the adjustment-of-status application. A filing submitted without required medical documentation may be rejected under the applicable filing rules. Because exceptions and category-specific requirements may apply, applicants should confirm the current instructions before submitting their application.
How to Find an Authorized Civil Surgeon
Applicants generally cannot use any doctor of their choosing for the immigration medical examination. The examination must be completed by a physician currently designated by USCIS as a civil surgeon, except where a specific exception applies.
Before scheduling an appointment, use the official USCIS civil surgeon search tool or contact USCIS for information about finding an authorized physician. Confirm that the doctor is currently designated and ask what identification and records the office requires.
When contacting a medical office, applicants may also ask about appointment availability, examination fees, laboratory costs, vaccination costs, and the time needed to complete the paperwork. These costs can vary by provider and by the examinations, tests, or vaccinations required. USCIS does not set one universal price for every medical examination.
What Documents Should You Bring?
Preparing documents in advance can help the civil surgeon review the applicant’s history and complete the examination. The precise requirements depend on the person’s circumstances and the doctor’s instructions.
Applicants should consider bringing the following items when relevant:
- Government-issued photo identification: Bring identification accepted by the civil surgeon’s office, such as a passport or another appropriate official document.
- Vaccination records: Bring written records showing previous vaccinations, including records from outside the United States when available.
- Medical records: Relevant records may help the physician understand medical history or determine whether further evaluation is needed.
- Medication information: A current list of medications and relevant treatment information may be useful during the medical history review.
- Immigration information: Bring the USCIS instructions, application information, or other materials requested by the civil surgeon’s office.
- Prior examination records: If an earlier immigration medical examination was completed, bring the related documentation if it may be relevant to the current case.
This list is a preparation guide, not a substitute for the instructions from the medical office or USCIS. Applicants should ask the civil surgeon what is needed before attending the appointment.
What Happens During the Medical Examination?
The civil surgeon follows the applicable U.S. public health and immigration medical examination instructions. The process generally includes reviewing medical history and conducting a physical examination. Depending on the applicant’s age, history, findings, and current requirements, laboratory tests or additional evaluations may also be necessary.
The examination addresses specified health-related grounds of inadmissibility under immigration law. These include certain communicable diseases of public health significance, vaccination requirements, and particular physical or mental disorders associated with harmful behavior, as well as other conditions defined by law and policy.
A medical condition does not automatically mean that an applicant is ineligible for an immigration benefit. The legal consequences depend on the condition, the applicable rules, the examination findings, and whether any permitted exception or waiver is available. Applicants should discuss medical questions with the civil surgeon and legal questions with a qualified immigration attorney.
Understanding Vaccination Requirements
Vaccination review is an important part of Form I-693 for many adjustment-of-status applicants. The civil surgeon reviews the applicant’s available vaccination records and determines whether the applicant meets the requirements that apply to their age and circumstances.
Applicants should bring reliable written vaccination documentation whenever possible. Records may come from medical providers, vaccination clinics, schools, or other appropriate sources. The records should include the dates of vaccine doses and other details needed for the physician to assess them. A verbal statement that a vaccine was received may not be sufficient to document a vaccination.
If records are incomplete or unavailable, the civil surgeon can explain the available options under the applicable medical instructions. Depending on the circumstances, this may involve additional vaccination, laboratory evidence of immunity where accepted, or documentation of a permitted reason a vaccine is not medically appropriate.
Vaccination requirements can change, and the requirements for immigration purposes are not necessarily identical to every recommendation made for general healthcare. Applicants should therefore rely on current CDC technical instructions and the civil surgeon’s assessment rather than an outdated list found online.
What If Your Vaccination Records Are From Another Country?
Many applicants received vaccinations before arriving in the United States. These records may be considered if they provide sufficient and reliable information for the civil surgeon to evaluate them under current requirements.
Bring the original records or other documentation requested by the physician. If the documents are written in a language other than English, ask the civil surgeon’s office whether an English translation is needed and what translation standards apply. The CDC’s instructions place responsibility on applicants to provide reliable English translations when necessary.
Do not alter dates, recreate records, or submit information that cannot be verified. If a record is missing or contains an apparent mistake, explain the circumstances to the civil surgeon and ask what documentation may be acceptable.
Why Must Form I-693 Be in a Sealed Envelope?
When the civil surgeon completes the examination, the physician generally provides the applicant with the completed Form I-693 in a sealed envelope for submission to USCIS, along with a copy for the applicant’s own records. Follow the current form instructions and the civil surgeon’s directions for submitting the report.
Applicants should not open, alter, or tamper with the sealed envelope intended for USCIS. If the envelope is opened or altered, USCIS may reject the medical report and require the applicant to obtain a properly sealed version. Before leaving the medical office, confirm that the envelope is sealed and that the office has provided a copy for personal records.
Keep the personal copy in a safe place. It can help the applicant retain a record of the examination and vaccination information, but it should not be substituted for the sealed report when USCIS requires the sealed original.
When Should You Submit Form I-693?
The correct submission timing depends on the current instructions for the immigration benefit being requested. For many applicants filing Form I-485, USCIS requires the medical examination report to be submitted with the adjustment-of-status application. Applicants should check the latest Form I-485 and Form I-693 instructions before mailing or electronically submitting any documents.
Submitting required medical documentation at the wrong time can cause processing problems. If the report is omitted when required, the filing may be rejected or the case may require further action, depending on the applicable rules and circumstances.
Applicants should not rely solely on older guidance that recommends waiting until USCIS requests the medical examination. Filing policies have changed over time, so verify the current requirements for the specific application and category.
How Long Is Form I-693 Valid?
Form I-693 validity has been the subject of USCIS policy changes. Under USCIS policy updated on June 11, 2025, a Form I-693 is generally valid only for the period during which the immigration benefit application or request with which it was submitted remains pending. If that application is denied or withdrawn, the report is no longer valid for a later application.
This means applicants should be cautious about relying on older online articles that describe a general multi-year validity period without explaining the newer policy. If an applicant files a subsequent immigration benefit application, USCIS generally requires a new Form I-693 with that application when a medical report is required.
The applicable rules can depend on the type of filing and the circumstances of the case. Before reusing an earlier medical report or filing a new application, consult the current USCIS policy and form instructions. Do not assume that a previously completed examination will automatically satisfy the requirement for a different or later application.
Common Form I-693 Mistakes to Avoid
Using a Physician Who Is Not Authorized
A medical examination completed by a physician who is not currently designated as a civil surgeon may not satisfy the requirement. Verify the physician’s designation before the appointment.
Leaving Out Vaccination Records
Incomplete records can make it harder for the civil surgeon to determine which vaccination requirements have been met. Gather available documentation and ask how to handle missing records.
Signing the Form Too Early
Applicants should follow the form instructions regarding signatures. The I-693 instructions direct applicants not to sign the form until the civil surgeon tells them to do so, and the applicant must sign in the physician’s presence when required by those instructions.
Opening the Sealed Envelope
The sealed report should remain sealed for submission to USCIS. Opening or altering the envelope can cause the agency to reject the report.
Following Outdated Validity Advice
Older articles may not reflect the June 2025 USCIS policy update. Confirm the current rules before relying on a prior medical examination for a pending or future application.
Submitting the Report at the Wrong Time
USCIS may require Form I-693 to accompany Form I-485. Check the current filing instructions for the specific application rather than assuming that the report can always be submitted later.
How the Medical Examination Fits Into Adjustment of Status
Adjustment of status is the process through which an eligible person already in the United States may apply to become a lawful permanent resident without completing immigrant visa processing abroad. The process involves eligibility requirements, forms, supporting evidence, and, in many cases, additional USCIS steps such as biometrics or an interview.
The medical examination addresses health-related requirements; it does not independently establish eligibility for permanent residence. USCIS considers the complete application, including family or employment eligibility where applicable, immigration history, admissibility, and required supporting evidence.
Applicants researching the adjustment-of-status process should review the requirements for their own category and confirm which documents must be submitted with the application. A medical examination is only one part of the overall process.
When May Legal Guidance Be Useful?
Some applicants can prepare for the medical examination by following USCIS instructions and the civil surgeon’s directions. Others may have circumstances that require a closer review of the immigration rules.
Case-specific legal guidance may be useful when the applicant is unsure whether a medical examination is required, has a prior immigration medical report, has received a notice about missing documentation, or is preparing a new application after an earlier application was denied or withdrawn. It may also be useful if the medical issue raises questions about immigration admissibility or whether a legal waiver is available.
Medical professionals determine the medical findings and complete the required examination. Immigration attorneys can explain how the applicable immigration rules may affect a case, but they do not replace the civil surgeon’s medical role. Applicants should avoid withholding relevant medical history or submitting inaccurate information on immigration forms.
For general information about immigration procedures and common filing questions, review the firm’s immigration FAQ resource. Individual circumstances should always be evaluated using the current official rules and the facts of the case.
Frequently Asked Questions
Can any doctor complete Form I-693?
No. The examination generally must be completed by a physician currently designated by USCIS as a civil surgeon, subject to limited exceptions. Applicants should verify the doctor’s designation before scheduling the examination.
Should I submit Form I-693 with Form I-485?
For many adjustment-of-status applicants, USCIS requires Form I-693 to be submitted with Form I-485. Review the current instructions for the relevant application category because requirements and exceptions may differ.
Can I open the sealed medical examination envelope?
No. Follow the civil surgeon’s instructions and keep the envelope intended for USCIS sealed. An opened or altered envelope may result in the report being rejected.
What if I cannot find my vaccination records?
Tell the civil surgeon that the records are unavailable and ask which options apply. The physician will assess the available documentation and determine whether further vaccination, testing, or other steps are appropriate under the current requirements.
Can I use the same Form I-693 for a later immigration application?
Under USCIS policy updated in June 2025, Form I-693 is generally valid only while the benefit application with which it was submitted remains pending. If that application is denied or withdrawn, the report is no longer valid for a subsequent application. Check the current USCIS policy before relying on a prior examination.
Does passing the medical examination guarantee a green card?
No. The medical examination addresses health-related requirements. USCIS separately evaluates the applicant’s eligibility for the immigration benefit and the other legal requirements that apply to the case.
Conclusion
Form I-693 is an important part of many adjustment-of-status applications. Applicants can prepare by finding an authorized civil surgeon, gathering identification and vaccination records, following the examination instructions, and keeping the completed medical report sealed for USCIS. They should also confirm when the report must be submitted and how the current validity policy applies to their case.
Because USCIS procedures can change, relying on outdated information may lead to avoidable filing problems. Review the current Form I-693 and Form I-485 instructions, consult official CDC guidance on vaccination requirements, and seek case-specific legal advice when the application or medical documentation presents a complicated issue.
Disclaimer: This article is for general informational and educational purposes only. It is not legal or medical advice and does not create an attorney-client relationship. Immigration requirements and public health guidance may change. The appropriate process depends on the applicant’s circumstances and the rules in effect at the time of filing. Consult current official USCIS and CDC guidance and qualified professionals for advice about an individual situation.
