What Do I Do With the Sealed Envelope After My Immigration Medical Exam?

The Sealed Envelope Is Your Form I-693

When you pick up your completed immigration medical exam results, the civil surgeon will give you Form I-693 in a sealed envelope. The envelope is sealed with the civil surgeon's signature and official stamp across the seal — this security measure is required by USCIS to ensure the integrity of the medical findings.

The sealed envelope contains your completed Form I-693, all laboratory results, vaccination records, and any other documentation the civil surgeon has included. Everything USCIS needs to review your medical exam is inside.

Do Not Open the Envelope

This is the most important rule: do not open the sealed Form I-693 packet intended for USCIS submission. Opening that packet may cause USCIS to reject it as improperly submitted. The clinic may provide a separate unsigned copy for the patient's records.

If the packet is opened — even accidentally — contact the civil surgeon's office immediately. Do not attempt to reseal it or submit it to USCIS. The civil surgeon will advise you on next steps.

How to Store the Envelope

Store the sealed envelope in a safe, dry place until you are ready to submit it to USCIS. Keep it flat to avoid bending or creasing. Do not store it in a location where it could be exposed to moisture, heat, or damage.

Many applicants keep the sealed envelope with their other important immigration documents — passport, I-485 receipt notice, attorney correspondence — so it is easy to find when needed.

When to Submit the Envelope to USCIS

For most adjustment of status applicants, Form I-693 is submitted to USCIS with the Form I-485 package. Check the current USCIS instructions for Form I-485 to confirm whether to include Form I-693 with the initial filing or bring it to your USCIS interview.

USCIS periodically updates its instructions on when and how to submit Form I-693. Your immigration attorney or the USCIS website will have the most current guidance. If you are filing without an attorney, review the Form I-485 instructions carefully before submitting.

What If the Envelope Is Damaged?

If the sealed envelope is damaged — torn, wet, or otherwise compromised — contact the civil surgeon's office immediately. Do not attempt to repair or re-seal the envelope yourself. The civil surgeon will advise on whether a new examination is needed or whether the damage can be addressed with a supplemental letter.

Requesting a Copy of Your Results

You are entitled to request a copy of your Form I-693 before the civil surgeon seals the envelope. This is the only opportunity to review your results before submission. If you did not request a copy at the time of pickup, you can ask the civil surgeon's office whether a copy is available — but note that the sealed envelope itself cannot be opened.