What is Form I-693?
USCIS Form I-693, officially titled the Report of Medical Examination and Vaccination Record, is the federal form used to document the results of an immigration medical exam. It is one of the most important documents in the green card application process.
The form captures three categories of information:
- The results of a complete physical examination performed by a USCIS-designated Civil Surgeon
- Your vaccination history and any vaccines administered during the exam
- The results of required laboratory tests, including TB blood testing and STI screenings
Once completed, the Civil Surgeon signs and seals the form in an envelope. You submit this sealed envelope to USCIS as part of your green card application — it must never be opened before submission.
Who Needs Form I-693?
Most applicants seeking to become lawful permanent residents (green card holders) in the United States are required to submit Form I-693. This includes:
Adjustment of Status
Applicants filing Form I-485 to adjust status to permanent resident from within the United States.
Consular Processing
Applicants applying for an immigrant visa at a U.S. consulate or embassy abroad.
Refugees & Asylees
Refugees and asylees applying for lawful permanent residence after one year in the U.S.
Special Immigrant Categories
Certain special immigrant visa categories as specified by USCIS policy.
Note: Not every visa category requires Form I-693. Nonimmigrant visa applicants (tourist, student, work visas) generally do not need an immigration medical exam unless specifically required by their visa category. When in doubt, consult your immigration attorney.
What Does Form I-693 Document?
Form I-693 is a multi-page document that captures a comprehensive picture of your health as it relates to USCIS admissibility standards. Here is what each section covers:
Physical Examination
A complete head-to-toe physical exam assessing your general health, vital signs, vision, hearing, and organ systems. The Civil Surgeon documents any findings relevant to USCIS inadmissibility grounds.
Vaccination Record
A review of your complete vaccination history against the USCIS-required vaccine schedule. Any missing vaccines are administered during the exam and documented. Waivers are noted when applicable.
Laboratory Test Results
Results from required blood tests including TB screening (QuantiFERON-TB Gold), syphilis (RPR), and gonorrhea testing for applicable age groups. Abnormal results trigger additional evaluation.
Mental Health & Substance Use Screening
A brief assessment for mental health conditions and substance use disorders that may be relevant to USCIS inadmissibility grounds. This is educational and clinical — not a judgment.
Civil Surgeon Certification
The Civil Surgeon's signature, license number, and USCIS designation number certifying that the exam was conducted in accordance with USCIS Technical Instructions.
The Role of the Civil Surgeon
A Civil Surgeon is a licensed physician who has been specifically designated by USCIS to perform immigration medical exams and complete Form I-693. This designation is not automatic — physicians must apply to USCIS, meet specific requirements, and agree to follow USCIS Technical Instructions.
This is a critical point: your personal physician, family doctor, urgent care provider, or any other licensed doctor who is not on the USCIS Civil Surgeon list cannot complete Form I-693. A form completed by a non-designated physician will be rejected by USCIS.
ImmigrationMedicalExams.com — USCIS-Designated Civil Surgeons Since 2007
Our clinic has been a USCIS-designated Civil Surgeon practice since 2007. Immigration medical exams are all we do — which means our team is among the most experienced in Southern California. We have completed thousands of Form I-693 exams with a first-time approval record we are proud of.
How the Form I-693 Process Works
Here is a simplified overview of the Form I-693 process from start to finish:
Schedule Your Appointment
Contact a USCIS-designated Civil Surgeon clinic to schedule your immigration medical exam. Gather your vaccination records, passport, and government-issued ID before your appointment.
Attend Your Exam
The Civil Surgeon performs a complete physical exam, reviews your vaccination history, administers any missing vaccines, and orders required laboratory tests.
Lab Results Are Processed
Required blood tests are sent to a certified laboratory. Results typically return within 1–3 business days. The Civil Surgeon reviews all results.
Form I-693 Is Completed
Once all results are in, the Civil Surgeon completes, signs, and dates Form I-693. The form is placed in an envelope, sealed, and stamped by the Civil Surgeon.
You Receive the Sealed Envelope
You receive the sealed Form I-693 envelope. Do not open it. Submit it to USCIS with your Form I-485 or bring it to your USCIS interview as instructed.
The Sealed Envelope Rule
One of the most important rules about Form I-693 is the sealed envelope requirement. Once the Civil Surgeon completes the form, it is placed in an envelope, sealed, and signed across the seal. This envelope must remain sealed until it is submitted to USCIS.
Do Not Open the Envelope
If the sealed envelope is opened — even accidentally — USCIS will reject the form and you will need to return to the Civil Surgeon for a new exam. Always keep the envelope sealed and store it in a safe place until submission.
Some Civil Surgeons, including our clinic, offer a digital copy review service for immigration attorneys who need to verify the form before submission. This review is done from a digital copy — the sealed envelope is never opened.
How Long Is Form I-693 Valid?
Form I-693 is generally valid for two years from the date the Civil Surgeon signs it. However, validity depends on when USCIS adjudicates your case — if your case is not decided within the validity window, you may need a new exam.
The clock starts when the Civil Surgeon signs the form.
Form I-693 is valid for two years from the signing date.
If USCIS has not adjudicated your case, you may need a new exam.
For the most current validity rules, always consult the USCIS website or your immigration attorney, as policies can change.
Frequently Asked Questions
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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 validity rules may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to your individual case.