Common I-693 Mistakes
That Cause RFEs

Why I-693 Errors Are So Costly

A Request for Evidence (RFE) is a formal USCIS notice asking you to provide additional information or correct an error in your application. When an RFE is triggered by a Form I-693 error, it typically means:

• Your case is paused until you respond
• You have a deadline (usually 87 days) to respond with a corrected form
• You may need to schedule a new immigration medical exam
• Your overall green card timeline is extended by months

The good news: virtually every I-693 RFE is preventable. The mistakes that trigger them are well-documented and avoidable when you work with an experienced Civil Surgeon.

Wrong Form Edition

USCIS periodically releases updated editions of Form I-693. Using an outdated edition — even one that is only slightly out of date — will result in an automatic rejection or RFE. The current edition date is printed in the bottom-left corner of the form.

Civil Surgeons are responsible for always using the current edition. How to avoid it: confirm with your Civil Surgeon that they are using the current USCIS-approved edition of Form I-693 before your exam. Our clinic always uses the current edition.

Missing or Incorrect Civil Surgeon Signature

Form I-693 requires the Civil Surgeon's signature in multiple locations — including the certification section and across the sealed envelope. Missing even one required signature will trigger an RFE.

Common signature errors include:

• Missing signature on Part 2 (Civil Surgeon Certification)
• Missing or illegible date next to the signature
• Signature not matching the Civil Surgeon's name as listed in the USCIS Civil Surgeon database
• Failure to sign across the sealed envelope flap

How to avoid it: before leaving the clinic, confirm that all required signatures and dates are present. Our Civil Surgeons perform a final review of every form before sealing.

Incomplete Vaccination Record

The vaccination section of Form I-693 must document every USCIS-required vaccine — either as administered, previously documented, or with a valid medical waiver. Common vaccination errors include:

• Leaving vaccine fields blank instead of marking "not applicable" or "waived"
• Failing to document vaccines the applicant already received
• Administering vaccines but failing to record the lot number and date
• Not documenting the basis for any vaccine waiver

How to avoid it: bring all vaccination records to your appointment. Our Civil Surgeons review every required vaccine against the USCIS schedule and document each one completely.

Missing or Incorrect Lab Results

Form I-693 requires documentation of specific laboratory tests — including TB testing (QuantiFERON-TB Gold), syphilis (RPR), and gonorrhea testing for applicable age groups. Common lab errors include:

• Missing lab results because the Civil Surgeon sealed the form before all results returned
• Incorrect lab values transcribed onto the form
• Failure to document follow-up for abnormal results
• Using a non-USCIS-approved lab

How to avoid it: never allow a Civil Surgeon to seal your Form I-693 before all lab results have returned and been reviewed. Our clinic waits for all results before completing and sealing the form.

Opened or Damaged Sealed Envelope

Once the Civil Surgeon seals and signs the Form I-693 envelope, it must be submitted to USCIS intact. An opened envelope — even one that was opened accidentally — cannot be resealed and accepted by USCIS. This requires a completely new immigration medical exam.

Common causes:

• Applicant opens the envelope out of curiosity
• Envelope is damaged in transit or storage
• Envelope seal breaks due to humidity or heat

How to avoid it: treat the sealed envelope as a legal document. Store it flat in a safe, dry location. Submit it to USCIS as soon as possible after receiving it.

Expired Form I-693

Form I-693 is valid for 2 years from the Civil Surgeon's signature date. If USCIS has not adjudicated your case before the form expires, you will need a new exam. Common expiration scenarios:

• Applicant schedules the exam too early (before filing I-485)
• USCIS processing delays cause the case to extend beyond the 2-year window
• Applicant files I-485 without the medical exam and then delays scheduling

How to avoid it: schedule your exam after filing Form I-485 and receiving your receipt notice, but not so early that the form risks expiring before your interview.

Frequently Asked Questions