I-693 Sealed vs Electronic: Handwritten Signatures & Clinic Checklist
If you file Form I-485 by mail, you must submit the original, unopened, sealed envelope from your civil surgeon. If you file I-485 online, you open that envelope yourself, scan the completed Form I-693, and upload it, but you keep the original sealed envelope safe until USCIS reaches a final decision. Never accept a Form I-693 that arrives unsealed.
TL;DR:
- Ensuring the envelope is properly sealed, initialed, and taped before leaving the clinic is crucial because USCIS can reject unsealed or tampered forms.
- Only handwritten signatures are accepted from civil surgeons; stamped, typed, or electronic signatures will cause the form to be rejected.
- The validity of Form I-693 now depends on the application date, not a fixed expiration, making timely submission more important than previous deadline concerns.
- For online filing, you must produce a high-resolution scan of the entire sealed envelope, maintaining its integrity, to avoid requests for evidence or delays.
- A damaged, opened, or lost sealed envelope warrants immediate contact with the civil surgeon for a replacement to prevent filing rejection or delays.
Table of Contents
- What USCIS rules actually require for sealing and signatures
- Step by step: mailing your I-693 versus uploading it online
- Protecting the sealed envelope from clinic to courthouse
- If the envelope was opened, lost, or already uploaded unsealed
- The submission mistakes that trigger RFEs or outright returns
- Why the sealed envelope survives even as e-filing expands
- How ImmigrationMedicalExams.com keeps your I-693 compliant
- Bookmark these official USCIS and CDC resources
- Sources
- FAQ
What USCIS rules actually require for sealing and signatures
The Form I-693 instructions are specific about what the civil surgeon must do before handing you the form. The civil surgeon has to place the completed exam in an envelope marked “DO NOT OPEN. FOR USCIS USE ONLY,” initial across the sealed flap, and cover those initials with clear tape. If the envelope arrives opened or the seal looks altered, USCIS can return the form outright.
Signatures matter just as much as sealing. USCIS expects handwritten signatures from the civil surgeon in the required fields, and a stamped or typed signature is grounds for rejection. Electronic signatures have a place in some USCIS benefit requests, but they do not substitute for the handwritten signature the Form I-693 instructions demand.
Validity is the third piece. Recent policy guidance ties the evidentiary validity of Form I-693 to the application it accompanies rather than to a fixed expiration window, a shift that took effect for forms signed on or after November 1, 2023.
In practice, this means:
- The civil surgeon seals, initials, and tapes the envelope before you leave the clinic.
- Handwritten signatures are required; stamps and typed names are not accepted.
- Form I-693 validity generally runs with the pending application, not a flat calendar deadline.
Step by step: mailing your I-693 versus uploading it online
The right process depends entirely on how you file your I-485.
Filing I-485 by mail:
- Receive the sealed envelope from your civil surgeon at the end of your exam.
- Place the unopened envelope inside your I-485 packet exactly as instructed.
- Label and assemble your mailing according to the I-485 filing instructions.
- Keep copies of everything you send and retain tracking information for the package.
Filing I-485 online:
- Open the sealed envelope only when you are ready to scan the completed Form I-693.
- Produce a high-resolution PDF scan of every page, front and back.
- Upload the scan to the correct evidence section in your USCIS online account, following the guided workflow or PDF upload option as your case allows.
- Retain the original sealed envelope. USCIS may ask to see it at your interview.
Pro Tip: Scan at 300 DPI or higher, crop out desk clutter or shadows, and save as PDF rather than JPEG. A blurry or cropped scan is one of the fastest ways to trigger a request for evidence over document quality.
USCIS cautions applicants not to upload any form unless it appears on the acceptable evidence list for that filing type, so check your account’s evidence checklist before you scan anything.
Protecting the sealed envelope from clinic to courthouse
A civil surgeon’s job does not end when the exam is finished. They must complete and sign Form I-693, seal it in an envelope labeled “DO NOT OPEN. FOR USCIS USE ONLY,” initial across the flap, and tape over those initials so any tampering is obvious. Most clinics will also provide a photocopy for your records if you ask.
Before you leave the appointment, check the envelope yourself:
- Confirm the “DO NOT OPEN” label is printed clearly on the front.
- Verify the civil surgeon’s initials cross the sealed flap.
- Check that clear tape fully covers the initials with no lifting or gaps.
Pro Tip: If anything looks off, ask for the envelope to be resealed or reissued before you leave the office. Catching a problem at pickup is far easier than fixing it after USCIS has flagged it.
At Immigrationmedicalexams, every completed exam goes through this same check before the applicant leaves, and we offer a replacement sealed envelope service for anyone who discovers a problem later or lost the original.
If the envelope was opened, lost, or already uploaded unsealed
Do not submit a Form I-693 that shows signs of tampering. If your envelope was opened by accident, damaged, or misplaced, contact the civil surgeon who performed your exam right away and ask for a replacement sealed envelope. Keep written notes of every call or e-mail so you have a record of the steps you took.
If you already filed your I-485 online and uploaded a scan, hold onto the original sealed envelope if you still have it. You may need to present it at your interview. If the original is gone entirely, the safest path is scheduling a new exam and getting a fresh sealed envelope rather than risking a rejected or incomplete filing.
- Contact your civil surgeon immediately if the seal looks broken or the envelope is missing.
- Document every communication in writing in case USCIS asks for an explanation.
- Consider an expedited exam if your interview date is close and you need a replacement fast.
The submission mistakes that trigger RFEs or outright returns
Most I-693 problems come from a short list of avoidable errors: an unsealed envelope, a tampered seal, a missing signature, an outdated form edition, a low-quality scan, or forgetting to include the I-693 at all when it is required with your I-485.
Sealed envelopes remain a chain of custody tool for the officer reviewing your case. Practical checks like initials across the flap, intact clear tape, and a legible “DO NOT OPEN” label are the clearest signs your form is ready to submit.
To avoid the common pitfalls:
- Use a pickup checklist to inspect the seal before leaving the civil surgeon’s office.
- Confirm you have the current form edition before your exam, since outdated editions can cause a return.
- Scan at high resolution and keep the physical original safe regardless of how you file.
- Never skip including the sealed envelope in a mailed I-485 package when it is required.
A deficient Form I-693 typically comes back as either a returned filing or a request for evidence, and either one adds weeks to your timeline. Addressing the issue as soon as you notice it, rather than waiting for USCIS to flag it, is the fastest way to stay on schedule.
Why the sealed envelope survives even as e-filing expands
The sealed envelope is not bureaucratic habit. It is a chain of custody mechanism that lets an adjudicator trust that the medical findings inside were never altered after the civil surgeon signed off. Civil surgeons already report certain findings electronically to public health authorities, but that reporting channel exists for surveillance purposes, not as a replacement for the applicant-facing sealed packet USCIS still requires.
Expect USCIS to keep expanding e-filing options gradually rather than eliminating the sealed envelope overnight. Until an official announcement says otherwise, treat the sealed original as the document of record and the scan as a convenience for online filing.
— ImmigrationMedicalExams Medical Team
How ImmigrationMedicalExams.com keeps your I-693 compliant
We specialize exclusively in immigration medical examinations and Form I-693, no primary care, urgent care, or sick visits, so every appointment is built around getting your sealed envelope right the first time. Standard processing takes about three days, with a two-day expedited option when your timeline is tight.
If your envelope was damaged, lost, or came from a clinic that made an error, we offer a replacement sealed envelope service and can help you prepare a scan-ready copy for online filing so you avoid a preventable RFE. Book a standard exam or expedited exam through our online scheduling, available 24/7, and see current package details on our pricing page.
Bookmark these official USCIS and CDC resources
- Visit the USCIS Form I-693 page to confirm current sealing and filing requirements.
- Check the Form I-693 instructions PDF before your exam to confirm you have the current edition.
- Review USCIS online filing options to see what evidence formats your case allows.
- Read the policy memo on I-693 validity to understand how long your form stays valid.
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 | USCIS
- Form I-693, Instructions for Report of Immigration Medical Examination and Vaccination Record
- Online Filing Options | USCIS
- PA-2025-08: Validity of Report of Immigration Medical Examination and Vaccination Record (Form I-693)
FAQ
What are the common reasons for I-693 rejection?
The most frequent causes are an opened or tampered sealed envelope, a missing handwritten signature, an outdated form edition, and a poor-quality scan when filing online. USCIS can also return the form if it was left unsealed when a sealed submission was required.
What are the new rules for form I-693?
Recent USCIS policy guidance ties the evidentiary validity of a properly completed Form I-693 to the pending application it supports, rather than a fixed expiration date, for forms signed on or after November 1, 2023. Applicants should still confirm the current form edition and sealing requirements before their exam.
How long does it take to get a Green Card after submitting I-693?
Processing time depends on the applicant’s specific I-485 case category and USCIS workload rather than the I-693 itself, so there is no single published timeline. A properly sealed and signed I-693 helps avoid delays caused by a returned form or a request for evidence.
Does USCIS require a blue or black ink signature?
USCIS requires a genuine handwritten signature from the civil surgeon in the required fields rather than a stamped or typed one. The form instructions do not specify an ink color, so the focus is on the signature being original and legible.