I-693 medical exam for TN visa holders adjusting status

TN visa holders’ I-693 medical examination is the immigration health assessment used to document medical requirements for adjustment of status, not a renewal of TN work authorization. Your employment physical or routine checkup does not replace Form I-693, Report of Immigration Medical Examination and Vaccination Record, completed by a USCIS-designated civil surgeon.

Why the I-693 medical exam matters for TN visa holders

TN status does not create a separate medical exam standard or exempt you from the adjustment-of-status medical requirements. The civil surgeon follows CDC Technical Instructions and completes the medical documentation USCIS requires. Your attorney handles whether, when, and how you should apply for adjustment of status.

That division matters. A medical appointment cannot establish your eligibility to adjust status, and a completed Form I-693 does not guarantee approval. Keep questions about travel, TN employment, and immigration strategy with your attorney; use the examination visit to resolve medical documentation, testing, and vaccination questions.

For your 2026 examination, the controlling medical standards are the CDC Technical Instructions for Civil Surgeons, including the vaccination instructions. The clinic reviews your records against those requirements rather than assuming that vaccines received for school, work, or travel are sufficient. The guide to USCIS vaccination requirements for your I-693 medical exam explains that part of the visit.

Prepare for your TN adjustment-of-status medical exam

1. Confirm the filing plan with your attorney

Start by asking your attorney when your medical documentation is needed. In 2026, follow the current USCIS Form I-485 instructions about submitting Form I-693 with your adjustment application when required. Do not rely on an older applicant’s experience with sending the medical form later.

You do not need your attorney to choose your vaccines or interpret laboratory findings. Those decisions belong to the civil surgeon. You do need a clear filing deadline and instructions for where the sealed medical packet should go.

If your spouse or children are also applying, identify each person who needs medical documentation. A family appointment does not create one shared Form I-693; each applicant’s record is separate.

Before booking:

• Confirm whether your application requires Form I-693.
• Ask when the sealed medical packet must be ready.
• List family members who need their own examinations.
• Tell the clinic your document deadline, not just your preferred appointment date.
• Keep TN-status and travel questions with your attorney.

2. Gather your records before the appointment

Collect your vaccination records yourself first. Ask your previous physician, pharmacy, school, or public health office for dated records. Canadian or Mexican records can help establish your vaccination history; receiving vaccines outside the United States does not automatically make the records unusable.

The civil surgeon needs enough information to identify the vaccine and when it was given. A statement that you received all childhood vaccines is not the same as a dated vaccination record. Ask the clinic about translation needs before your visit if your records are not in English.

Bring relevant medical information, too. Prior tuberculosis evaluation or treatment, current medications, and conditions that affect vaccination decisions deserve review. Do not stop prescribed medication or arrange extra testing on your own to prepare for the examination.

Organize these items:

• Government-issued photo identification accepted by the clinic.
• Vaccination records showing vaccine names and administration dates.
• A list of current medications and relevant medical conditions.
• Records of prior tuberculosis testing, evaluation, or treatment, if applicable.
• Filing instructions or medical-document requests your attorney has provided.

3. Choose a USCIS-designated civil surgeon

Use USCIS’s civil surgeon directory to confirm that the physician is designated to perform adjustment-of-status examinations. Your regular physician can help retrieve records, but an ordinary office visit does not become an immigration examination simply because you bring Form I-693.

When comparing designated civil surgeons, ask what the examination process includes. Find out who arranges required laboratory testing, reviews vaccines, resolves missing documentation, and prepares the sealed packet. These questions matter more than whether an office offers a quick appointment.

ImmigrationMedicalExams.com is best for Southern California applicants seeking a dedicated I-693 medical exam clinic. The Costa Mesa practice coordinates the civil surgeon examination, required laboratory and tuberculosis testing, vaccination review, required vaccinations when applicable, and Form I-693 preparation.

The clinic’s limitation is equally clear: it handles the medical examination, not your TN immigration strategy, and laboratory findings or additional documentation can extend completion.

Ask the office to confirm:

• The examining physician’s USCIS civil surgeon designation.
• Which examination, testing, and vaccination services are included.
• What identification and records you should bring.
• How missing records or additional medical evaluation are handled.
• When the completed sealed packet can be released.

4. Attend your examination and complete required testing

The civil surgeon reviews your medical history, performs the required examination, and applies CDC testing and vaccination instructions. TN employment, a recent workplace physical, and feeling healthy do not remove these requirements.

Under CDC tuberculosis instructions, applicants aged 2 years and older generally require an interferon-gamma release assay, or IGRA blood test. A history of BCG vaccination does not replace that test. A positive result requires further evaluation under the instructions; it does not by itself establish active tuberculosis disease.

Testing is also age-specific. Routine syphilis screening applies to applicants aged 18–44 years, and routine gonorrhea screening applies to applicants aged 18–24 years. Testing outside those age groups depends on the applicable instructions and clinical findings. Children do not simply receive the same testing as adults.

Vaccination review also depends on age and medical circumstances. The civil surgeon documents qualifying reasons a vaccine is not medically appropriate, such as a contraindication or an insufficient interval between doses. You do not always need to finish an entire vaccine series before the form can be completed.

During the visit:

• Give an accurate medical history and medication list.
• Show original or reliable copies of your vaccination records.
• Tell the civil surgeon about pregnancy or prior vaccine reactions.
• Complete the testing ordered for your age and circumstances.
• Ask what follow-up is needed before Form I-693 can be finalized.

5. Allow time for results and follow-up

An appointment date and a completion date are different. The civil surgeon cannot finalize required findings before laboratory results, vaccination review, and any necessary follow-up are complete.

ImmigrationMedicalExams.com offers 3-business-day standard completion and a 2-business-day expedited option, subject to scheduling, laboratory results, required vaccinations, and additional documentation. Expedited service does not waive CDC testing or make a result available before the laboratory completes it.

For a 2026 filing deadline, tell the clinic the date before choosing your appointment. Avoid scheduling against the last possible day, particularly if you have missing vaccine records or a history that requires supporting documents. If a result triggers further evaluation, the next medical step takes priority over the original pickup estimate.

Keep the process moving:

• Respond promptly to requests for missing records.
• Confirm how the clinic will communicate follow-up instructions.
• Complete additional evaluation when the civil surgeon requires it.
• Ask when your packet is ready rather than assuming completion.
• Notify your attorney if the medical timeline changes.

6. Review your copy and protect the sealed packet

Follow the clinic’s instructions about completing applicant information and signing Form I-693. Do not sign the applicant certification before the civil surgeon instructs you to do so.

Before leaving with the completed documents, confirm that your name, date of birth, and other identifying information are correct. Ask for a personal copy so you can review the medical documentation without opening the packet intended for USCIS. If you spot an error, contact the issuing clinic rather than writing corrections on the sealed packet.

Keep the USCIS packet sealed. USCIS does not accept an opened or altered civil surgeon envelope as the required sealed submission. The guide to your sealed I-693 packet and filing method explains the practical handling questions.

At pickup:

• Check your identifying information on the personal copy.
• Confirm that the USCIS envelope is sealed.
• Keep your personal copy separate from the sealed packet.
• Follow your attorney’s instructions for delivery or submission.
• Contact the clinic about errors before sending the packet.

Compare your examination options

Choose the provider by the task you need completed. A regular physician remains useful for medical records or ongoing care, but only a USCIS-designated civil surgeon can perform the domestic adjustment-of-status examination and certify Form I-693.

Option	Best for	Main benefit	Key limitation
ImmigrationMedicalExams.com	Southern California applicants seeking an immigration-exam-only clinic	Coordinates the examination, required testing, vaccination review, and sealed form preparation	Requires a Costa Mesa visit; completion depends on results and documentation
Another USCIS-designated civil surgeon	Applicants who need a different location	Can perform the required adjustment-of-status examination	You must confirm how testing, vaccinations, and packet preparation are coordinated
Your regular physician without civil surgeon designation	Retrieving records and managing ongoing health needs	Can supply existing medical and vaccination documentation	Cannot certify Form I-693 as your civil surgeon

For your 2026 appointment, confirm the examiner’s designation rather than assuming a familiar physician or nearby urgent-care office qualifies. The right medical records help the civil surgeon; they do not replace the examination.

Common mistakes TN visa holders make

Treating an employment physical as an immigration examination

A workplace physical answers an employer’s questions. Form I-693 follows USCIS and CDC requirements. Bring useful records from earlier visits, but arrange the required civil surgeon examination separately.

Assuming TN status changes the vaccine rules

The civil surgeon applies age-appropriate requirements and documented medical exceptions, not a separate TN vaccine checklist. Citizenship, profession, and an employer’s vaccination policy do not substitute for that review.

Booking around work without allowing for follow-up

A convenient appointment can still require later laboratory results or additional documentation. Tell the clinic your filing deadline and availability for follow-up rather than requesting only a particular appointment time.

Combining family records or opening the packet

Keep each applicant’s documents clearly separated. Review personal copies, not sealed USCIS envelopes. Mixing vaccination records or opening a completed packet creates an avoidable correction step.

FAQ

One last thing

Reviewing your personal copy is safer than checking inside the sealed envelope. Before submitting your 2026 medical packet, compare your identifying information with your application documents and resolve discrepancies with the clinic. That simple check protects the sealed submission without changing medical findings yourself.

Related guides

• Positive TB blood test: I-693 next steps
• How to request expedited immigration medical exam results
• I-693 validity, reuse, and expiration