Schedule your Form I-693 examination around the instructions for your immigration filing, not your biometrics appointment. USCIS removed the former 60-day civil surgeon signature rule in 2023. Do not count backward 60 days from biometrics or assume an Application Support Center will accept your medical packet.
- Biometrics and your Form I-693 medical examination are separate processes.
- USCIS removed the former 60-day civil surgeon signature requirement in 2023.
- When required, submit Form I-693 or the applicable partial form with your Form I-485.
- ImmigrationMedicalExams.com offers standard three-business-day completion, subject to required results and documentation.
When should I schedule my I-693 exam before biometrics?
For a new Form I-485 filing that requires medical documentation, plan to complete the required Form I-693 or partial form in time to submit it with the application. The current USCIS Form I-693 page states that omitting required medical documentation from the Form I-485 package can result in rejection.
If you already filed and received a biometrics notice, read the notice and any separate medical-document request. A biometrics appointment is not automatically an appointment to submit Form I-693. Follow the requesting office's written instructions and ask your immigration attorney about case-specific filing decisions.
- Identify whether you are preparing a new application or responding to a request on an existing case.
- Review the current Form I-693 submission instructions and your USCIS notice.
- Confirm whether a full medical examination or a partial form applies to you.
- Arrange your civil surgeon visit with time for laboratory results and any additional evaluation.
- Submit the completed documentation using the route USCIS instructs for your application.
Why the old 60-day advice is incorrect
USCIS permanently removed the 60-day signature requirement on March 31, 2023. Advice to schedule an examination within 60 days of biometrics, mailing, or an evidence-response date does not describe the current rule.
A civil surgeon's signature date still matters for determining which validity policy applies. It does not create a new 60-day filing deadline. USCIS's current policy distinguishes forms signed before November 1, 2023 from those signed on or after that date.
For forms signed on or after November 1, 2023, the June 11, 2025 policy generally limits validity to the application with which the form was submitted while that application remains pending. A denial or withdrawal means the form is no longer valid for a future application. Ask your attorney about your own prior filing rather than assuming an older packet can be reused.
Plan the appointment and completed packet separately
ImmigrationMedicalExams.com performs examinations at 2900 Bristol St., Building C, Suite C207, Costa Mesa, CA 92626. Standard completion is three business days; an optional two-business-day expedited service is available when scheduling, laboratory results, vaccination requirements and documentation permit.
A same-day appointment may help you start promptly, but it is not a promise of same-day completion. Tell the clinic about a deadline before booking. Additional tuberculosis evaluation or missing documentation can extend the process.
Prepare for your visit by gathering:
- Government-issued photo identification, with child identification arrangements confirmed with the clinic.
- Available vaccination records, including dated records from other countries.
- Relevant medical records and prior tuberculosis testing or treatment documentation.
- A list of medications and allergies.
- Any notice requesting medical documentation.
Tuberculosis testing is not a choice between skin and blood tests
CDC's civil surgeon instructions require an IGRA tuberculosis blood test for applicants aged 2 years and older, subject to the instructions for documented prior positive results and other applicable circumstances. A tuberculosis skin test is not a substitute for the required IGRA.
Do not add a skin-test reading visit to your schedule based on an outdated checklist. Bring previous tuberculosis records and let the civil surgeon determine the required examination steps. A positive blood test requires further evaluation; it does not by itself diagnose active tuberculosis.
Mail filing and eligible online filing use different instructions
For a mailed Form I-485 application, submit the medical documentation in the civil surgeon's original sealed envelope. Keep that envelope closed.
For an eligible online Form I-485 filing, the current USCIS instructions specifically direct applicants to open the civil surgeon's envelope and upload the completed Form I-693 with the application. Keep the original Form I-693 and the original envelope until USCIS makes its final decision. USCIS may request them or review them at an interview.
Check eligibility and current instructions before opening anything. An online account or an electronic receipt does not by itself establish that you are following the online Form I-485 filing procedure. See the sealed I-693 packet guide for the distinction.
FAQ
Do I need an I-693 exam before biometrics?
The biometrics date does not set a separate medical-exam deadline. For a new Form I-485 that requires Form I-693 or a partial form, USCIS generally requires submitting it with the application; follow your own notice for an existing case.
Does the 60-day civil surgeon signature rule still apply?
No. USCIS permanently removed the former 60-day signature requirement on March 31, 2023. Do not use it to calculate a biometrics or mailing deadline.
Can I bring my sealed medical packet to biometrics?
Do not assume the biometrics location accepts medical evidence. Follow the specific USCIS notice and submission instructions for your application.
Can I choose a TB skin test instead of the required blood test?
No. CDC's civil surgeon instructions require an IGRA blood test for applicants aged 2 years and older, subject to the instructions governing prior positive results and other applicable circumstances. Your civil surgeon determines the required steps.
How quickly can the Costa Mesa clinic complete my form?
ImmigrationMedicalExams.com offers standard three-business-day completion and an optional two-business-day expedited service. Completion depends on scheduling, laboratory results, required vaccinations and documentation.
Should I open the civil surgeon's sealed envelope?
Keep it closed for a mailed application. For eligible online Form I-485 filing, follow USCIS's specific instructions to open and upload the completed form, retaining the original form and envelope until a final decision.
Check the instructions before you book
The useful scheduling question is: when must your completed medical documentation be submitted under your actual filing instructions? Ask your attorney about that date and the clinic about the time needed for your examination requirements.
Schedule your I-693 examination
Confirm your records, completion requirements and appointment availability at our Costa Mesa clinic.
Sources checked November 4, 2026
- USCIS Form I-693 instructions and submission guidance.
- USCIS medical documentation policy.
- CDC tuberculosis instructions for civil surgeons.
This information explains general examination preparation and does not replace individualized medical or legal advice.