The Civil Surgeon Reviews Your Results and Completes Form I-693

Once your immigration medical examination is finished, the civil surgeon does not immediately hand you a completed form. Instead, the physician must wait for all required laboratory results to be returned and reviewed before Form I-693 can be finalized. Required tests — including the TB/IGRA blood test, syphilis serology, and gonorrhea test — are typically processed by the laboratory within one business day of your appointment.

After all results are in, the civil surgeon carefully reviews each finding, documents any conditions that require follow-up or treatment, and completes every section of Form I-693 in accordance with USCIS Technical Instructions. This review step is what ensures your form is accurate, complete, and acceptable to USCIS. Errors or omissions on Form I-693 are a leading cause of Requests for Evidence (RFEs), so this review is critical.

At ImmigrationMedicalExams.com, Standard 3-Day Processing means your completed sealed form is ready within 3 business days of your appointment. If you selected 2-Day Expedited Processing, your form is ready within 2 business days.

The Sealed Envelope: What It Is and Why It Matters

When the civil surgeon has completed Form I-693, the form is placed inside an envelope that is sealed and signed across the flap. This is known as the sealed envelope, and it is a formal USCIS requirement. The seal certifies that the form has not been altered or tampered with since it left the civil surgeon's office.

USCIS will not accept a Form I-693 that arrives in an opened, damaged, or resealed envelope. If the seal is broken for any reason — even accidentally — the form is considered compromised and you will need to undergo a new immigration medical examination. This is why protecting the sealed envelope from the moment you receive it until you submit it to USCIS is so important.

You should never open the envelope yourself, and you should not allow anyone else — including your immigration attorney — to open it. The envelope is addressed to USCIS and is intended to be opened only by a USCIS officer.

How You Receive Your Completed Form I-693

When your sealed Form I-693 is ready, our office will notify you that it is available for pickup at our Costa Mesa clinic. In-person pickup is strongly recommended because it eliminates the risk of the envelope being damaged, lost, or opened in transit.

If you are unable to pick up the form in person, please contact our office in advance to discuss your options. An authorized representative — such as a family member or your immigration attorney — may be able to pick up the form on your behalf with proper authorization. Please do not simply send someone without contacting us first, as we need to verify authorization before releasing the sealed form.

What to Do With Your Sealed Form I-693

Once you have your sealed Form I-693 in hand, store it in a safe place where it will not be bent, torn, or exposed to moisture. Do not place it at the bottom of a bag where it could be crushed, and do not fold it. The envelope should remain flat and intact.

Keep the sealed envelope until you are ready to submit it to USCIS. Do not open it, do not make copies of the contents, and do not attempt to read the form through the envelope. If you have questions about what the civil surgeon found during your examination, you may ask our office — but the sealed form itself must remain sealed.

Submitting Form I-693 to USCIS

There are two ways to submit your sealed Form I-693 to USCIS, depending on your case. If you are filing Form I-485 (Application to Register Permanent Residence or Adjust Status) by mail or online, you may include the sealed Form I-693 envelope with your I-485 package. USCIS will open the envelope when they process your application.

Alternatively, if you have already filed your I-485 or if USCIS instructs you to bring the form to your adjustment of status interview, you will hand the sealed envelope directly to the USCIS officer at your interview. The officer will open the envelope in your presence. Consult with your immigration attorney to determine which submission method applies to your case.

• Option 1: Include the sealed envelope with your Form I-485 filing package
• Option 2: Bring the sealed envelope to your USCIS adjustment of status interview
• Option 3: Submit in response to a USCIS Request for Evidence (RFE)
• Always follow your attorney's instructions regarding submission timing and method

Validity Period and Timing Considerations

Form I-693 has a validity period. Under current USCIS policy, a properly completed Form I-693 signed by a civil surgeon is generally valid for 2 years from the date the civil surgeon signed it, provided it is submitted to USCIS within that window. However, USCIS policies can change, and your immigration attorney is the best source of guidance on whether your form will still be valid at the time of submission.

If there is a significant delay between your medical examination and your I-485 filing or USCIS interview, confirm with your attorney that your Form I-693 is still within its validity period. If it has expired, you will need to schedule a new immigration medical examination.