What Is Form I-693?
Form I-693 (Report of Immigration Medical Examination and Vaccination Record) is the official USCIS form used to document the results of an immigration medical exam. It records the applicant's physical examination findings, vaccination history, and required laboratory test results.
The form must be completed by a USCIS-designated Civil Surgeon — not a personal physician, urgent care provider, or any other healthcare professional. This requirement is non-negotiable: only Civil Surgeons are authorized by USCIS to conduct immigration medical exams and certify Form I-693.
USCIS uses Form I-693 to determine whether an applicant has any health-related grounds of inadmissibility under the Immigration and Nationality Act (INA). The form is a critical component of the green card application process — without it, USCIS cannot adjudicate your Form I-485.
In plain language: Form I-693 is the medical report that tells USCIS you have been examined by an authorized physician, you have received the required vaccines, and you do not have any health conditions that would make you inadmissible to the United States.
Who Needs to File It?
Most applicants for lawful permanent residence (a green card) who are adjusting status inside the United States must submit Form I-693. This includes:
- Immediate relatives of U.S. citizens (spouses, children, parents)
- Family preference category applicants
- Employment-based green card applicants
- Diversity visa lottery winners adjusting status
- Refugees and asylees adjusting status (even if they had a prior overseas exam)
- Certain special immigrant categories
Nonimmigrant visa applicants (tourist, student, and work visas) generally do not need Form I-693. The form is specific to the adjustment of status process for lawful permanent residence.
Filing Form I-485?
If you are filing Form I-485, you almost certainly need Form I-693. Confirm with your immigration attorney if you are unsure about your specific situation.
Who Can Complete It?
Only a USCIS-designated Civil Surgeon can complete and sign Form I-693. Civil Surgeons are licensed physicians who have been specifically authorized by USCIS to perform immigration medical exams. This designation is separate from a standard medical license — a physician must apply to USCIS and meet specific requirements to become a Civil Surgeon.
You can find a USCIS-designated Civil Surgeon using the USCIS Civil Surgeon locator tool at uscis.gov. Search by zip code to find authorized providers near you.
Your personal physician, urgent care provider, or any other healthcare professional — even a licensed MD — cannot complete Form I-693 unless they are specifically designated as a Civil Surgeon by USCIS. A form completed by an unauthorized provider will be rejected by USCIS.
Our clinic is a USCIS-designated Civil Surgeon practice. Schedule directly — no referral needed. We handle the entire Form I-693 process from exam to sealed envelope.
Overview of Every Section
Form I-693 is divided into eight parts. Here is what each part covers and who is responsible for completing it.
Part 1: Applicant Information
Completed by the applicantFull legal name, date of birth, country of birth, A-Number (if any), and current address. This section is filled out by the applicant before or at the time of the exam.
Part 2: Civil Surgeon Certification
Completed by the Civil SurgeonCertifies that the exam was conducted per USCIS Technical Instructions. Includes the Civil Surgeon's name, address, USCIS designation number, signature, and date.
Part 3: Medical Examination
Completed by the Civil SurgeonPhysical exam findings. Documents any conditions relevant to inadmissibility grounds. Includes findings for each organ system reviewed during the examination.
Part 4: Vaccination Record
Completed by the Civil SurgeonDocuments all vaccines reviewed and administered. Must reflect the complete USCIS-required vaccine schedule for the applicant's age and medical history.
Part 5: Tuberculosis Testing
Completed by the Civil SurgeonDocuments TB test type (TST or IGRA), date administered, result, and any follow-up required. Required for all applicants 2 years of age and older.
Part 6: Syphilis Testing
Completed by the Civil SurgeonDocuments RPR (rapid plasma reagin) test result. Required for applicants 15 years of age and older.
Part 7: Gonorrhea Testing
Completed by the Civil SurgeonDocuments gonorrhea test result. Required for applicants 15 years of age and older.
Part 8: Additional Remarks
Completed by the Civil SurgeonSpace for the Civil Surgeon to document additional findings, waivers, explanations, or any other information relevant to the applicant's inadmissibility determination.
The Civil Surgeon's Role
The Civil Surgeon is responsible for the accuracy and completeness of Form I-693. Their responsibilities include:
- Conducting the full physical examination per USCIS Technical Instructions
- Reviewing and documenting the applicant's vaccination history
- Administering any required vaccines not yet documented
- Ordering and reviewing required laboratory tests (TB, syphilis, gonorrhea)
- Documenting any findings relevant to inadmissibility grounds
- Signing and dating the completed form
The Civil Surgeon's signature certifies to USCIS that the exam was conducted properly and in accordance with USCIS Technical Instructions. Any error or omission on the form is the Civil Surgeon's responsibility — which is why choosing an experienced, USCIS-designated Civil Surgeon matters.
Experience Matters
An inexperienced Civil Surgeon may miss required components, use an outdated form edition, or make documentation errors that trigger a USCIS Request for Evidence. This can add months to your case and require a completely new exam.
The Sealed Envelope Rule
After completing Form I-693, the Civil Surgeon places it in an envelope, seals it, and signs across the seal. This sealed envelope must be submitted to USCIS intact — the integrity of the seal is a formal requirement.
Never open the envelope — even accidentally opening it can invalidate the form and require a completely new exam. If the envelope is damaged or opened before submission, contact the Civil Surgeon immediately. Do not attempt to reseal it.
Do Not Open the Sealed Envelope
Do not open the sealed envelope under any circumstances. An opened envelope cannot be resealed and accepted by USCIS. If the seal is broken, you will need a completely new immigration medical exam.
Civil Surgeon Seals It
The Civil Surgeon places the completed form in an envelope, seals it, and signs across the seal.
You Transport It
You receive the sealed envelope and are responsible for keeping it intact until submission to USCIS.
USCIS Opens It
USCIS opens the sealed envelope when processing your case or at your interview. Only USCIS should open it.
Validity Period
Form I-693 is valid for 2 years from the date the Civil Surgeon signs it. USCIS must adjudicate your case while the form is still valid. If your case is not adjudicated before the form expires, you will need a new immigration medical exam.
Timing your exam strategically is important. Schedule your exam after filing Form I-485 — but not too early. If your case takes longer than expected, an exam completed too early may expire before USCIS adjudicates your case.
2-Year Validity Window
Form I-693 is valid for exactly 2 years from the Civil Surgeon's signature date. After that, a new exam is required.
Clock Starts at Civil Surgeon Signature
The validity period begins on the date the Civil Surgeon signs the form — not the date of your exam or the date you submit it to USCIS.
Plan Around Your USCIS Interview Date
If you know your USCIS interview date, schedule your exam so the form will still be valid on that date — with some buffer.
Timing tip: Most immigration attorneys recommend scheduling your immigration medical exam after you have filed Form I-485 and received your receipt notice, but not more than 12–18 months before your expected interview date.
Submitting to USCIS
There are two accepted methods for submitting Form I-693 to USCIS. Your immigration attorney can advise which method is best for your specific case.
Submit with Form I-485
Include the sealed I-693 envelope in your I-485 filing package. USCIS will open it when processing your case. This method is convenient and ensures USCIS has the form on file from the start — but it means your form's validity period begins running immediately.
Bring to Your USCIS Interview
If you did not include Form I-693 with your I-485 filing, bring the sealed envelope to your USCIS interview. The officer will open it at the interview. This method allows you to schedule your exam closer to your interview date, reducing the risk of expiration.
Request for Evidence (RFE)
USCIS may send a Request for Evidence (RFE) asking you to submit Form I-693 if it was not included with your initial I-485 filing. Respond promptly — RFEs have strict deadlines, and failure to respond can result in denial of your application.
Tip: Ask your immigration attorney which submission method is best for your specific case. The right choice depends on your case timeline, USCIS processing times, and how quickly your interview is expected to be scheduled.
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Medical & Legal Disclaimer: The information on this page is provided for general educational purposes only and does not constitute medical or legal advice. Immigration medical exam requirements, USCIS policies, and Form I-693 requirements may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to your individual case.