Overview
A USCIS immigration medical exam is required for most people applying for lawful permanent residence — commonly known as a green card. The exam serves a specific legal purpose: it documents that the applicant does not have any health conditions that would make them inadmissible under U.S. immigration law.
The results of the exam are recorded on Form I-693, the official USCIS Report of Medical Examination and Vaccination Record. This form must be completed by a USCIS-designated Civil Surgeon — a licensed physician specifically authorized by USCIS to perform immigration medical exams. Your personal doctor cannot complete this form.
Not every visa applicant needs an immigration medical exam. The requirement depends entirely on your immigration pathway — whether you are adjusting status inside the United States, going through consular processing abroad, or applying under a special immigrant category. The sections below break down exactly who is required to complete Form I-693.
Quick answer: If you are applying for a green card from inside the United States by filing Form I-485, you almost certainly need an immigration medical exam. If you are applying for a temporary (nonimmigrant) visa such as a tourist, student, or work visa, you generally do not.
Adjustment of Status Applicants
The largest group required to complete Form I-693 is adjustment of status applicants — people who are already inside the United States and are applying to become lawful permanent residents by filing Form I-485 (Application to Register Permanent Residence or Adjust Status).
This requirement applies across virtually all family-based, employment-based, and diversity visa categories. Common examples include:
- Immediate relatives of U.S. citizens — spouses, unmarried children under 21, and parents
- Family preference category applicants (F-1, F-2A, F-2B, F-3, F-4)
- Employment-based green card applicants (EB-1, EB-2, EB-3, EB-4, EB-5)
- Diversity visa (DV) lottery winners who are adjusting status from within the U.S.
- Certain special immigrant categories filing Form I-485
Filing Form I-485? You Need an Exam.
If you are filing Form I-485, you almost certainly need an immigration medical exam. Form I-693 is a required supporting document for your I-485 package. USCIS will not approve your green card application without it.
Consular Processing Applicants
Applicants who are outside the United States and applying for an immigrant visa at a U.S. consulate or embassy must also complete an immigration medical exam. However, the process is different from the Civil Surgeon exam used for adjustment of status.
For consular processing, the exam is conducted by a USCIS-approved panel physician located at or near the U.S. embassy or consulate in the applicant's home country. Panel physicians are designated by the U.S. Department of State — they are not the same as Civil Surgeons, and their exam results are submitted directly to the consulate as part of the immigrant visa application.
Important distinction: This page focuses on Civil Surgeon exams for adjustment of status applicants inside the United States. If you are going through consular processing abroad, contact the U.S. embassy or consulate in your country for a list of approved panel physicians.
Refugees and Asylees
Refugees and asylees who have been in the United States for at least one year and are applying to adjust their status to lawful permanent resident are also required to complete Form I-693.
It is important to note that refugees may have already completed a medical exam abroad before being admitted to the United States — this is a separate exam conducted by a panel physician as part of the refugee admissions process. However, that overseas exam does not satisfy the Form I-693 requirement. A new Civil Surgeon exam is still required when adjusting status inside the U.S.
Note for refugees: Even if you completed a medical exam before entering the U.S., you will need a new Form I-693 from a USCIS-designated Civil Surgeon when you apply to adjust your status. The two exams serve different legal purposes and are not interchangeable.
Special Immigrant Categories
Certain special immigrant visa categories also require Form I-693 as part of the adjustment of status process. These include, but are not limited to:
Special Immigrant Juvenile Status (SIJS)
Minors who have been abused, neglected, or abandoned and are applying for a green card through the SIJS pathway.
Religious Workers
Ministers and non-minister religious workers applying for lawful permanent residence under the EB-4 category.
Certain Broadcasters
Employees of qualifying international broadcasting organizations applying for special immigrant status.
Other USCIS-Specified Categories
Additional special immigrant categories as specified by current USCIS policy. Requirements may vary.
Special immigrant categories can have unique requirements and nuances. Always verify your specific category's medical exam requirements with your immigration attorney before scheduling your exam.
Who Does NOT Need an Exam
Nonimmigrant visa applicants generally do not need an immigration medical exam. If you are applying for a temporary visa to visit, study, or work in the United States, Form I-693 is not required. This includes:
- Tourist / Visitor Visa (B-1/B-2) — Short-term visits for tourism, business, or medical treatment.
- Student Visa (F-1) — Full-time academic study at a USCIS-approved school or university.
- Specialty Occupation Work Visa (H-1B) — Temporary employment in a specialty occupation.
- Intracompany Transferee Visa (L-1) — Transfers of employees within multinational companies.
- Extraordinary Ability Visa (O-1) — Individuals with extraordinary ability in their field.
- Exchange Visitor Visa (J-1) — Participants in approved exchange visitor programs.
- Most other temporary (nonimmigrant) visa categories — Unless specifically required by the visa category.
U.S. citizens and lawful permanent residents renewing their green card (Form I-90) also do not need a new immigration medical exam unless specifically required by USCIS in their individual case.
Not sure if you need an exam? Ask your immigration attorney — or call our office at 714-760-4538 and we can help you find out.
When to Get Your Exam
Timing matters when it comes to your immigration medical exam. Form I-693 has a validity period — generally two years from the date the Civil Surgeon signs the form. Getting the exam too early can cause the form to expire before USCIS adjudicates your case, requiring you to repeat the entire exam.
As a general best practice, schedule your exam after you have filed Form I-485 or received your USCIS receipt notice, but before your USCIS interview. This timing helps ensure the form remains valid throughout the adjudication process.
After Filing I-485
Once you have filed Form I-485 and received your receipt notice, you have a confirmed case number. This is the ideal time to schedule your Civil Surgeon exam.
Before Your USCIS Interview
USCIS may ask you to bring your sealed Form I-693 to your interview. Have it ready in advance — do not wait until the interview notice arrives.
Within the 2-Year Validity Window
Form I-693 is valid for 2 years from the Civil Surgeon's signature date. If your case is still pending near the expiration, contact your Civil Surgeon about a re-examination.
For the most current guidance on Form I-693 validity and timing, consult the USCIS website or your immigration attorney, as policies can change.
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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.