I-693 Physical Exam for Green Card Applicants
If you are filing Form I-485, you must have a USCIS-designated civil surgeon complete Form I-693 and submit it with your application. No exceptions. Schedule your civil surgeon appointment, bring Part 1 of Form I-693 already filled out, your government-issued ID, and your vaccination records. USCIS and the CDC set the rules. The civil surgeon executes them.
What you need to know upfront:
- Form I-693 documents your immigration medical exam results for USCIS to determine you are not inadmissible on health-related grounds.
- As of December 2, 2024, Form I-693 must be submitted with your Form I-485 at initial filing, or your I-485 may be rejected.
- Only a USCIS-designated civil surgeon can complete the form. Your regular doctor cannot sign it.
- The completed form is handed to you in a sealed envelope. Do not open it.
Table of Contents
- What does the I-693 physical exam cover?
- Who needs an I-693 and when should you schedule it?
- How do you find a civil surgeon and prepare for the appointment?
- What does the I-693 exam cost, and how long does it take?
- Why does USCIS return or delay Form I-693?
- How Immigrationmedicalexams handles your I-693 exam
- Key Takeaways
- The detail that actually decides your timeline
- Book your I-693 exam in Southern California
- Useful sources
What does the I-693 physical exam cover?
The I-693 immigration medical exam is a federally mandated health screening, not a general checkup. Its sole purpose is to identify medical conditions that make an applicant inadmissible under the Immigration and Nationality Act (INA). The civil surgeon checks for communicable diseases of public health significance, untreated tuberculosis, physical or mental disorders with associated harmful behavior, and drug abuse or addiction. CDC Technical Instructions set the exact testing and vaccination standards every civil surgeon must follow.
Medical history and physical examination
The civil surgeon reviews your full medical history and conducts a head-to-toe physical exam. This includes vision, hearing, heart, lungs, abdomen, skin, and neurological assessments. Mental health history is also reviewed.
Required laboratory tests
TB testing is required for all applicants aged 2 and older. Syphilis and gonorrhea testing follow CDC age-based guidelines and risk-factor criteria. If a test result is abnormal, the civil surgeon has authority to order follow-up testing or require treatment before signing the form. That determination can delay your sealed I-693, so address any known conditions before your appointment.
I-693 vaccination requirements
The vaccination chart on Form I-693 is one of the most scrutinized sections. Every row must have at least one entry. A blank row is grounds for USCIS to return the form or issue a Request for Evidence (RFE). The civil surgeon reviews your existing records and administers any missing vaccines on the spot.
| Vaccine Group | Acceptable Proof | Notes |
|---|---|---|
| — | Vaccination card, medical record | Required for eligible age groups |
| Influenza | Annual vaccination record | Required for flu season applicants |
| Td/Tdap | Immunization record | Booster requirements apply by age |
| MMR | Immunization record | Two doses typically required |
| Varicella | Record or documented immunity | Serology accepted as proof |
| Hepatitis B | Immunization record | Three-dose series |
| Meningococcal | Immunization record | Age-based requirement |
| Pneumococcal | Immunization record | Required for certain age groups |
Pregnant applicants may defer certain live vaccines. The civil surgeon will note the deferral on the form and the row still receives an entry. For details on pregnancy-related deferrals, confirm with your civil surgeon before the appointment.
Pro Tip: Bring translated vaccination records from your home country. Complete records reduce repeat vaccinations, cut your time at the clinic, and often lower your total out-of-pocket cost.
Who needs an I-693 and when should you schedule it?
Most applicants filing Form I-485 for adjustment of status must submit a complete Form I-693. Certain refugees and asylees follow modified rules and may only need to complete the vaccination portion. If you entered the U.S. after an overseas immigration medical exam conducted by a panel physician, that exam does not substitute for the civil surgeon’s assessment when you adjust status domestically. A prior overseas panel physician exam cannot replace the civil surgeon’s vaccination assessment in most adjustment-of-status cases. You still need the full domestic exam.
Timing matters more than ever after December 2, 2024:
- Submit Form I-693 with your Form I-485 at initial filing. Submitting late risks rejection of your I-485.
- Schedule your civil surgeon appointment before you file, not after.
- Allow time for lab results and paperwork processing. Most dedicated clinics return a sealed I-693 within a few business days.
On validity: As of June 11, 2025, USCIS updated its policy to clarify that Form I-693 is generally valid only for the specific immigration benefit application with which it was submitted. If your I-485 is denied or withdrawn, you will need a new Form I-693 for any subsequent application. Plan accordingly. If your case is pending for an extended period and USCIS has reason to believe your medical status has changed, an officer can request an updated exam even if your original I-693 is otherwise valid.
How do you find a civil surgeon and prepare for the appointment?
Use the USCIS “Find a Civil Surgeon” tool to locate a designated physician near you. “Designated” is not a courtesy title. It means USCIS has specifically authorized that physician to conduct immigration medical exams and that they are legally bound to follow CDC Technical Instructions. Your regular doctor, urgent care clinic, or local hospital cannot complete Form I-693 unless they hold that designation.
Step-by-step preparation checklist
- Download and print the most current version of Form I-693 from USCIS.gov.
- Complete Part 1 in full. Leave the signature line blank. The civil surgeon must witness you sign.
- Bring a valid government-issued photo ID (passport preferred).
- Bring all vaccination records, including overseas records with translations if applicable.
- Bring any prior medical records relevant to chronic conditions, mental health history, or prior TB treatment.
- If you are pregnant, bring documentation from your OB-GYN for vaccine deferral purposes.
- Minors must be accompanied by a parent or legal guardian who can provide consent and access to the child’s medical history.
For a complete document checklist, the what to bring guide covers every item by applicant type.
What to expect at the appointment
The civil surgeon reviews your Part 1, conducts the physical exam, draws lab samples, and reviews your vaccination records. Any missing vaccines are administered on-site. Once all results are in and the form is complete, the civil surgeon signs and seals Form I-693 in an envelope. You receive the sealed envelope. Submit it to USCIS without opening it. USCIS will not accept Form I-693 if the envelope has been opened or altered in any way.
For applicants who had a panel physician exam overseas: bring that documentation to the appointment. The civil surgeon may reference it for medical history, but they will still complete the full domestic assessment as required.
What does the I-693 exam cost, and how long does it take?
The I-693 immigration medical exam is not covered by most standard health insurance plans. Civil surgeon clinics typically operate on a direct-pay model. Costs vary by clinic and location. An all-inclusive flat fee at a dedicated immigration medical clinic covers the physical exam, required lab tests (TB, syphilis, gonorrhea where applicable), and any vaccines needed at the time of the appointment. That flat-fee model eliminates surprise charges for individual line items.
What to expect on cost and timing:
- All-inclusive flat-fee pricing covers exam, labs, and vaccines administered at the visit.
- Insurance rarely reimburses the I-693 exam. Confirm with your insurer before assuming coverage.
- Same-day appointments are available at dedicated civil surgeon clinics.
- Sealed paperwork is typically ready within 2–3 business days after the exam.
On validity timing: Since Form I-693 is now tied to the specific application it accompanies, the practical advice is simple. Complete your exam as close to your I-485 filing date as possible. Do not get the exam months in advance and sit on it. If your application is later denied or withdrawn, that I-693 cannot be reused. You would need a new exam for any subsequent filing.
If your I-693 expires before USCIS adjudicates your case, review the guidance on expired Form I-693 to understand your options before acting.
Why does USCIS return or delay Form I-693?
Most returns and RFEs are preventable. The problems are almost always the same.
Common reasons USCIS returns or delays Form I-693:
- Incomplete vaccination chart. A single blank row is enough to trigger a return.
- Missing civil surgeon signature or stamp/seal on the form or envelope.
- Expired form edition. Always use the most current version from USCIS.gov.
- Tampered or opened envelope. Any sign of tampering causes automatic rejection.
- Missing lab results or documentation for required tests.
- Untreated Class A conditions. If the civil surgeon identifies a Class A condition (such as active TB or a communicable disease), the form cannot be signed until treatment is completed or a waiver is obtained. Civil surgeons have authority to require follow-up testing or treatment before completing the form.
Before you leave the clinic, confirm:
- Every row of the vaccination chart has at least one entry.
- The civil surgeon has signed the form and sealed the envelope in your presence.
- The envelope is intact, with no tears, staples through the seal, or re-taping.
- You have a personal copy of your completed form before it is sealed.
- The form edition matches the current version on USCIS.gov.
Keeping a photocopy of the completed form before sealing gives you a reference if USCIS issues an RFE and you need to identify what was documented.
How Immigrationmedicalexams handles your I-693 exam
Immigrationmedicalexams operates exclusively as a USCIS-designated civil surgeon clinic in Southern California. Every appointment is focused on one thing: completing your Form I-693 correctly the first time.
What the service includes:
- USCIS-designated civil surgeon conducting the full exam per CDC Technical Instructions.
- All-inclusive flat fee covering the physical exam, required lab tests, and vaccines administered at the visit.
- Same-day appointments with no long wait times.
- Sealed Form I-693 typically ready within 2–3 business days.
- Multilingual staff to assist applicants who need support in languages other than English.
- Group and family scheduling for households with multiple applicants.
- 100% accuracy guarantee on completed paperwork.
Over 450 five-star Google reviews reflect consistent, on-time delivery of sealed I-693 forms for green card applicants across Southern California. The clinic serves applicants from Los Angeles, Orange County, and surrounding areas.
Key Takeaways
Form I-693 must be submitted with Form I-485 at initial filing, completed by a USCIS-designated civil surgeon following CDC Technical Instructions, with every vaccination chart row filled in and the sealed envelope intact.
| Point | Details |
|---|---|
| Submit with I-485 | Since December 2, 2024, Form I-693 must be filed with Form I-485 at initial filing or the I-485 may be rejected. |
| Use a designated civil surgeon | Only a USCIS-designated civil surgeon can legally complete Form I-693; your regular doctor cannot sign it. |
| Complete the vaccination chart | Every row must have at least one entry; a single blank row is enough for USCIS to return the form. |
| Never open the sealed envelope | Any sign of tampering causes automatic USCIS rejection; submit the envelope exactly as the civil surgeon sealed it. |
| Immigrationmedicalexams | Dedicated civil surgeon clinic in Southern California offering same-day appointments, all-inclusive flat-fee pricing, and a typical 2–3 day turnaround on sealed I-693 paperwork. |
The detail that actually decides your timeline
Most green card applicants focus on the big documents: the I-485, the financial affidavits, the supporting evidence. The I-693 gets treated as an afterthought, something to handle at the last minute. That is exactly when it causes the most damage.
A single blank row in the vaccination chart, a civil surgeon who is not actually USCIS-designated, or an envelope that gets opened by accident can set a case back by months. These are not rare edge cases. They are the most common reasons USCIS issues RFEs on medical submissions. The December 2, 2024 concurrent-submission rule made the stakes higher. There is no longer a window to fix a missing I-693 after filing. It has to be right before the I-485 goes in the mail.
The applicants who move through this process without delays treat the I-693 the same way they treat every other critical document: they prepare early, they use the right provider, and they verify every line before leaving the clinic.
Book your I-693 exam in Southern California
Immigrationmedicalexams is the direct alternative to hunting for a general practitioner who may or may not hold a USCIS civil surgeon designation. The clinic handles only immigration medical exams, which means no scheduling conflicts with unrelated patients, no guessing whether the paperwork meets USCIS standards, and no surprise charges.
The all-inclusive flat fee covers your physical exam, required lab tests, and any vaccines you need at the appointment. Same-day slots are available. Families and groups can book together. The sealed Form I-693 is typically ready within 2–3 business days, keeping your I-485 filing on schedule.
Book your appointment at Immigrationmedicalexams today. If you want to review what the exam covers before you arrive, the I-693 service overview walks through every step.
This article is general information, not legal or medical advice. Confirm current USCIS requirements and your specific filing obligations with USCIS.gov or a qualified immigration attorney before submitting your application.
Useful sources
- Form I-693, Report of Immigration Medical Examination and Vaccination Record — USCIS
- USCIS Policy Manual, Volume 8, Part B, Chapter 2 — Medical Examination and Vaccination Record
- USCIS Policy Manual, Volume 8, Part B, Chapter 3 — Applicability of Medical Examination and Vaccination Requirement
- USCIS Policy Manual, Volume 8, Part B, Chapter 6 — Responsibilities of Designated Civil Surgeons
- CDC Technical Instructions for Civil Surgeons
- USCIS Vaccination Requirements for Civil Surgeons
- USCIS Find a Civil Surgeon Tool
- Form I-693 Instructions (PDF) — USCIS
- USCIS Alert: I-693 Now Required with Form I-485
- Complete Guide to Form I-693 — Immigrationmedicalexams
- What to Bring to Your Immigration Medical Exam — Immigrationmedicalexams