Why the Sealed Envelope Matters

The sealed envelope is the chain of custody mechanism for Form I-693. USCIS requires that the form be delivered in a sealed envelope to ensure that the contents have not been altered after the civil surgeon completed the examination. A broken seal, missing signature, or missing stamp is one of the most common — and most preventable — causes of RFEs on Form I-693.

What the Civil Surgeon Must Do

After completing Form I-693, the civil surgeon must: (1) place the completed form in an envelope, (2) seal the envelope, (3) sign across the seal (so that any tampering would be visible), and (4) stamp the envelope with the civil surgeon's official USCIS stamp.

All four steps are required. An envelope that is sealed but not signed across the seal, or signed but not stamped, is deficient. USCIS will issue an RFE requesting a properly sealed envelope.

What Attorneys Should Verify Before the Client Leaves

Attorneys should instruct clients to verify the following before leaving the civil surgeon's office: (1) the envelope is sealed, (2) the civil surgeon has signed across the seal, (3) the civil surgeon's official stamp appears on the envelope, and (4) the applicant's name and date of birth are visible on the outside of the envelope (some civil surgeons write this information on the envelope for identification purposes).

If any of these elements are missing, the client should ask the civil surgeon to correct the issue before leaving. It is far easier to correct a deficiency at the civil surgeon's office than to obtain a corrected envelope after the fact.

Can Attorneys Get a Copy of Form I-693?

Yes. Attorneys should request a copy of Form I-693 for their files before the civil surgeon seals the envelope. This is standard practice and allows the attorney to review the form for errors — incorrect applicant information, missing vaccination entries, incomplete sections — before the envelope is sealed.

Once the envelope is sealed, the attorney cannot review the form without invalidating the exam. Requesting a copy before sealing is the only opportunity to catch errors.

What Happens If the Envelope Is Opened

If the sealed envelope is opened before USCIS receives it — for any reason — the exam is invalid. The applicant must undergo a new immigration medical exam at their own expense. There are no exceptions to this rule.

Attorneys should instruct clients in writing not to open the envelope under any circumstances. If a client opens the envelope (for example, because they wanted to review the form), the attorney should advise the client to schedule a new exam immediately rather than attempting to re-seal the envelope.

How to Submit the Sealed Envelope to USCIS

The sealed envelope can be submitted to USCIS in two ways: (1) with Form I-485 at the time of filing, or (2) at the adjustment of status interview. Some USCIS field offices prefer one method over the other — attorneys should check the local office's current practice.

If submitting by mail with Form I-485, place the sealed envelope inside the mailing package without opening it. Do not staple or punch holes in the sealed envelope. USCIS will open the envelope when processing the case.

If submitting at the interview, the applicant should bring the sealed envelope to the interview and present it to the USCIS officer. The officer will open the envelope at the interview.

Storing the Sealed Envelope Before Submission

The sealed envelope should be stored in a secure location until it is submitted to USCIS. Attorneys who hold the envelope on behalf of their clients should store it in a secure file and document the chain of custody. Do not store the envelope in a location where it could be accidentally opened or damaged.