2026 I-693: Avoid RFEs by Checking Edition, Vaccines, and Seal
USCIS accepts the 01/20/25 edition of Form I-693 for exams signed on or after July 3, 2025, and it is the version civil surgeons should be using throughout 2026. Under current policy, an I-693 is generally valid only for the specific benefit application it was filed with, so timing your exam close to your I-485 submission is important. Schedule with a USCIS-designated civil surgeon and check the edition date and signature before you leave the office.
TL;DR:
- The 01/20/25 edition of Form I-693 is required for exams signed on or after July 3, 2025, and must be checked immediately after the appointment to avoid rejection.
- Starting June 11, 2025, USCIS limits I-693 validity to the specific application it was filed with, necessitating a new exam if the original application is denied or withdrawn.
- Civil surgeons follow CDC guidelines for TB, syphilis, gonorrhea testing, and vaccinations, with most test results available in 72 hours and accuracy in documentation critical for acceptance.
- Prepare for the exam with official vaccination records, ensure labs and vaccines are handled on-site, and coordinate timing with your I-485 filing to prevent delays or RFEs.
- Choosing specialized immigration medical clinics with flat-price packages increases the likelihood of correct, timely completion, especially if you have a tight filing schedule.
Table of Contents
- Which I-693 edition to use and how to check it
- USCIS policy updates affecting I-693 validity and submission
- What the civil surgeon exam includes
- How to prepare for the I-693 appointment
- Common reasons for delays or RFEs, and how to avoid them
- Fees, pricing models, and what to ask a civil surgeon clinic
- What happens at the appointment and how the sealed envelope works
- Why specialization matters for completing the 2026 I-693 correctly
- Official USCIS and CDC guidance to consult
- Getting your I-693 done right the first time
- Sources
- FAQ
Which I-693 edition to use and how to check it
The 01/20/25 edition is the one USCIS expects for exams signed on or after July 3, 2025. Older editions are only accepted within narrow windows tied to the signature date, so a form signed before that cutoff on a prior edition may still work, but anything signed afterward must use the current version. Our breakdown of the edition update covers the transition in more detail.
The edition date and OMB expiration are printed in small type at the bottom left of the form’s first page. Before you leave the civil surgeon’s office, check that the printed date matches the current edition, that the civil surgeon signed and dated it correctly, and that the envelope is sealed. Catching a mismatch on-site takes a minute; catching it after USCIS rejects your filing costs weeks. Our edition date walkthrough walks through exactly what to look for.
USCIS policy updates affecting I-693 validity and submission
Effective June 11, 2025, USCIS changed how long an I-693 remains valid. Under this policy, described in the USCIS Policy Manual, a completed I-693 is generally valid only for the immigration benefit application it was submitted with. If that underlying application is denied or withdrawn, the medical exam tied to it is no longer valid for a future filing, even if the form itself has not expired.
This builds on an earlier shift: USCIS removed the so-called 60-day rule in 2023, easing some of the earlier timing pressure around how soon after signature an I-693 needed to be filed. The practical result for 2026 applicants is that the exam and the green card application need to move together. If you had a prior application denied or withdrawn and you are refiling, plan on a new medical exam rather than reusing the old one, since USCIS will not treat it as valid for the new filing.
What the civil surgeon exam includes
The exam itself follows CDC Technical Instructions, and civil surgeons document each component directly on the form.
- Tuberculosis screening relies on an FDA-approved IGRA test such as QuantiFERON or T-SPOT, with chest x-rays ordered when indicated and results typically classified as Class B0, B1, or B2 depending on findings.
- Syphilis and gonorrhea testing requires paired treponemal and non-treponemal results, with titers and any prior treatment documented when applicable.
- Vaccinations are checked against your history and CDC’s required schedule, with doses and dates recorded on Part 10 of the form.
IGRA results are typically available within 72 hours, and civil surgeons must enter certain TB classifications into eMedical within 5 business days after signing the I-693, according to CDC’s tuberculosis technical instructions. Applicants with an infectious TB classification cannot receive final clearance until health department evaluation documentation is on file. The worksheet entries in Part 8 and the vaccination record in Part 10 are where most reviewable errors show up, so accuracy there directly affects whether USCIS accepts the form without questions.
How to prepare for the I-693 appointment
A smooth appointment depends on showing up with the right paperwork rather than relying on memory.
- Bring official, translated vaccination records along with prior medical records and government-issued photo ID; verbal history alone is not something a civil surgeon can document.
- Confirm your clinic performs labs and administers vaccines on-site, since externally pre-ordered tests are often not accepted for I-693 purposes.
- Coordinate the exam date with your I-485 filing timeline, and loop in your attorney if you have one, so the exam and the application move together rather than sitting apart for months.
Pro Tip: Request your vaccination records from your pediatrician or prior physician a week before your appointment. Same-day requests often arrive too late to bring with you.
Our pre-appointment checklist covers document specifics in more detail if you want to prepare further in advance.
Common reasons for delays or RFEs, and how to avoid them
Most Requests for Evidence trace back to a handful of preventable issues rather than anything medically complicated.
- Outdated edition: confirm the printed edition date matches what is currently accepted before the appointment ends.
- Incomplete vaccine rows: check that every required vaccine has a date, dose number, or documented exemption on Part 10.
- Opened envelope: a sealed I-693 that arrives opened can be rejected outright, so keep it sealed unless you are filing online and following USCIS’s upload instructions.
- Missing signature or date: the civil surgeon’s signature and date must be present and legible before you leave.
If you are filing electronically, follow USCIS’s specific guidance on when it is acceptable to open the envelope to scan the form, and keep the original sealed copy in case USCIS requests it later. Running through this list while still at the clinic, before the civil surgeon steps away, catches nearly everything that would otherwise turn into a delay weeks down the line.
Fees, pricing models, and what to ask a civil surgeon clinic
There is no government-set fee for the I-693 exam. USCIS confirms that civil surgeons and clinics set their own pricing, which means costs vary widely depending on location and what is included. A transparent flat-package price should cover the exam itself, vaccine review and administration, on-site lab work, and a completed, sealed I-693, along with printed copies of your records if you need them for your own files.
Expedited options make sense when you have an upcoming interview date or an RFE deadline that a standard turnaround will not meet. Before booking, ask any clinic directly about turnaround time, whether labs and vaccines are handled in the same visit, and whether the quoted price is genuinely all-inclusive.
What happens at the appointment and how the sealed envelope works
The visit generally follows a predictable sequence from check-in to signed form.
- Check-in and review of your Part 1 information and medical history.
- Physical exam, followed by any ordered lab work such as TB screening or syphilis and gonorrhea testing.
- Vaccine administration for any gaps identified against the CDC schedule.
- Civil surgeon review of all results, followed by signing and sealing the completed I-693.
Before leaving, inspect the envelope to confirm it is sealed and that the edition, signature, and date all look correct. If you plan to file online, USCIS allows opening the envelope to upload the form, but you should retain the original sealed paperwork in case it is requested later. Our step-by-step visit guide walks through what to expect at each stage in more detail.
Why specialization matters for completing the 2026 I-693 correctly
Clinics that handle nothing but immigration medical exams tend to avoid the errors that trip up general practices juggling sick visits and physicals alongside I-693 paperwork. ImmigrationMedicalExams has specialized exclusively in immigration medical examinations and Form I-693 since 2007, with no primary care, urgent care, or sick visits mixed in.
- We use a flat-package pricing model designed to avoid unexpected add-on costs.
- Standard processing runs approximately 3 days, with a 2-day expedited option when timing is tight.
- Online scheduling is available 24/7, and all required labs and vaccines are handled on-site in one visit.
We frequently see applicants who ran into delays, missing vaccination documentation, or errors from exams performed elsewhere. Because our team works with nothing but I-693 cases, catching an incomplete vaccine row or a mismatched edition before the form is sealed is part of the standard process, not an afterthought.
Official USCIS and CDC guidance to consult
For the source rules behind everything above, review the USCIS Policy Manual on I-693 validity, the official I-693 form and instructions, and CDC’s Technical Instructions for Civil Surgeons. Verifying edition dates and vaccination requirements directly at these sources is worth the few minutes it takes, especially close to a filing deadline.
Getting your I-693 done right the first time
If you need a green card medical exam completed correctly without guessing about edition dates, sealed envelope rules, or vaccine documentation, our USCIS Immigration Medical Exam service covers the civil surgeon exam, required labs, vaccine review and administration, and final I-693 preparation in one visit.
This fits particularly well if you have an interview date approaching or already ran into problems with an exam performed elsewhere, since correcting incomplete vaccination records or fixing an outdated edition is common work for us. Choose the Standard 3-Day exam for routine timelines or the 2-Day Expedited option when your filing window is tight. Book online any time through our scheduling system to get started.
This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.
Sources
- Report of Immigration Medical Examination and Vaccination Record (Form I-693) — USCIS
- Technical Instructions for Civil Surgeons — CDC
FAQ
What is the latest edition of Form I-693?
The current accepted edition is dated 01/20/25, and it applies to exams signed on or after July 3, 2025, according to USCIS. Older editions are only accepted within limited windows tied to the signature date, so always confirm the printed edition before your appointment ends.
What are the new rules for Form I-693?
Effective June 11, 2025, USCIS policy generally ties an I-693’s validity to the specific benefit application it was submitted with. If that application is denied or withdrawn, the medical exam is no longer valid for a future filing, so a new exam is typically needed when refiling.
How much does an I-693 medical fee cost?
There is no government-set fee for the exam, since USCIS confirms that civil surgeons and clinics determine their own pricing. Costs vary by location and what is included, so ask any clinic whether their price covers the exam, labs, vaccines, and the completed sealed form together.
What changes will be made to green cards in 2026?
Nothing publicly documented points to a change specific to green card issuance itself for 2026, but the medical exam process continues to operate under the validity rule that took effect June 11, 2025. Applicants should focus on timing their I-693 exam close to their I-485 filing rather than expecting a separate 2026-specific change.
— ImmigrationMedicalExams Medical Team