Step 1: Identify the Ground of Inadmissibility

Before filing Form I-601, you need to know exactly which ground of inadmissibility you are seeking to waive. The ground of inadmissibility is identified on Form I-693 — specifically, the Class A finding made by the civil surgeon.

Request a copy of Form I-693 before the civil surgeon seals the envelope, or ask the civil surgeon to explain the finding to you at the time of the exam. The specific ground determines which waiver standard applies and what documentation you need.

Step 2: Gather Supporting Documentation

The supporting documentation for a medical waiver depends on the type of finding. For communicable disease and mental disorder/substance use disorder waivers, you will need: current medical documentation from the treating physician or specialist, a summary of the diagnosis and treatment history, current treatment plan and medications, prognosis and assessment of future risk, and documentation of treatment compliance.

For hardship-based waivers, you will also need: documentation of the qualifying relative's circumstances, evidence of hardship (medical records, financial records, school records for children), and personal statements from the applicant and qualifying relative.

Step 3: Complete Form I-601

Form I-601 is available on the USCIS website (uscis.gov). Complete the form carefully and accurately. The form asks for information about the applicant, the ground of inadmissibility, and the basis for the waiver request.

Attach all supporting documentation to the completed form. Organize the documentation clearly — a well-organized submission is easier for USCIS to review and is more likely to result in a prompt decision.

Step 4: File With USCIS

For adjustment of status applicants (applicants in the United States), Form I-601 is filed with the USCIS service center that has jurisdiction over your Form I-485. Check the current USCIS filing instructions for Form I-601 to confirm the correct filing address.

Include the required filing fee with your submission. Current fee information is available on the USCIS website. Keep a copy of everything you submit.

Step 5: Respond to Any USCIS Requests

After filing, USCIS may issue a Request for Evidence (RFE) asking for additional documentation. Respond to any RFE promptly and completely. An incomplete or late response can result in denial.

USCIS will notify you of the decision by mail. If the waiver is approved, your Form I-485 adjudication will proceed. If the waiver is denied, you have options — see the related article on what happens if a waiver is denied.

Working With an Immigration Attorney

Medical waiver applications are complex. An immigration attorney with experience in medical inadmissibility cases can help you identify the correct waiver standard, gather the right documentation, and present the strongest possible record. The investment in legal representation is often well worth it given the stakes involved.