When you’re navigating the U.S. immigration process, there are many forms and requirements to keep track of. One important piece of the puzzle is Form I-693, officially known as the Report of Medical Examination and Vaccination Record. This form plays a crucial role in ensuring that applicants meet the health standards required to live in the United States. Understanding what Form I-693 is, why it’s needed, and who must submit it can help you avoid delays and make your immigration journey smoother.
What Is Form I-693?
Form I-693 is essentially a medical report that confirms you don’t have any health conditions that would make you inadmissible to the United States. The form is completed by a USCIS-designated civil surgeon after you undergo a thorough medical examination.
This exam checks for communicable diseases like tuberculosis and syphilis, verifies that you have received required vaccinations, and screens for any physical or mental disorders that could pose a risk to public health or safety. The purpose is to protect both you and the community by ensuring that applicants meet certain health standards before being granted immigration benefits.
Who Needs to Submit Form I-693?
If you are applying for a green card through adjustment of status within the United States, you will almost certainly need to submit Form I-693. This includes most applicants seeking permanent residency, whether through family sponsorship, employment, asylum, or other immigration pathways. The form may also be required in some other immigration benefit cases, so it’s always a good idea to check with an immigration attorney or official USCIS guidance to be sure.
The medical examination must be performed by a civil surgeon, a doctor authorized by USCIS to conduct these exams and complete Form I-693. You can find a list of designated civil surgeons on the USCIS website. When you go for your exam, you should bring identification, your vaccination records, any relevant medical history, and payment for the exam fee. In some cases, additional tests like chest x-rays may be required.
By understanding these basics about Form I-693, you’ll be better prepared to meet USCIS requirements and avoid common pitfalls in your immigration process.
The Medical Examination Process
Once you know that you need to submit Form I-693, the next step is to schedule your medical examination with a USCIS-designated civil surgeon. You can find a list of civil surgeons on the USCIS website, which makes it easier to locate one near you.
During your appointment, the civil surgeon will conduct a thorough medical examination. This includes a physical check-up, a review of your vaccination history, and any necessary lab tests or chest x-rays, especially if you have risk factors for tuberculosis or other communicable diseases. Be sure to bring a valid government-issued photo ID, your vaccination records, a list of any medications you are taking, and payment for the exam fee.
The civil surgeon will also review your medical history and determine which vaccinations you need based on your age, medical records, and CDC guidelines. If you are missing any required vaccines, the doctor will administer them during the exam. After completing all necessary tests and vaccinations, the civil surgeon will fill out Form I-693 and seal it in an envelope for you to submit to USCIS. This sealed envelope is important because it protects your medical information and ensures the form is official.
Completing Form I-693
Form I-693 is a detailed document that requires accurate and truthful information from both you and the civil surgeon. As the applicant, you will complete the initial sections, providing your personal information and signing the form to authorize the medical examination.
The civil surgeon then completes the medical sections, documenting the results of your exam, any lab tests, and vaccination records. They must sign and date the form, certifying under penalty of perjury that they hold a valid medical license and that the exam was conducted according to USCIS and CDC guidelines. If you require any follow-up tests or referrals, those must be completed before the civil surgeon signs off on the form.
It’s important to note that USCIS requires the form to be submitted in a sealed envelope, exactly as the civil surgeon provides it, to maintain the integrity of the medical exam. The form must be legible, complete, and valid at the time of submission. USCIS officers will review the form based on the CDC’s technical instructions effective on the date the civil surgeon signed it, meaning you won’t need to update the form for new requirements that came after that date.
Recent Policy Changes (Effective December 2, 2024 / January 22, 2025)
Starting December 2, 2024, USCIS implemented a significant change: applicants must now submit Form I-693 at the same time as their Form I-485 (application to adjust status). This policy aims to reduce delays caused by Requests for Evidence (RFEs) and prevent outright rejections of green card applications due to missing or late medical exam documentation.
Additionally, medical exams signed by civil surgeons after November 1, 2023, are now valid indefinitely. This means once you have a completed and signed Form I-693, you don’t have to worry about it expiring while your application is pending, which was a common concern in the past.
Another important update effective January 22, 2025, is that COVID-19 vaccination documentation is no longer required for adjustment of status applicants. This change aligns with updated public health guidance and simplifies the vaccination requirements for many applicants.
These policy updates reflect USCIS’s efforts to streamline the immigration process, reduce administrative burdens, and provide clearer guidance to applicants and medical professionals alike.
Vaccination Requirements
Vaccinations are a key part of the Form I-693 medical examination. The U.S. government requires applicants to be vaccinated against several communicable diseases to protect public health. These vaccines are based on recommendations from the Centers for Disease Control and Prevention (CDC) and vary depending on your age and medical history.
You won’t need the Covid vaccine anymore but all other vaccination requirements remain in place. These typically include vaccines for diseases like measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, varicella (chickenpox), influenza, and others.
When you go for your medical exam, bring any vaccination records you have. The civil surgeon will review your history and determine which vaccines you need based on current guidelines. If you’re missing any required vaccines, the doctor can administer them during the exam or you can get them beforehand from your own healthcare provider and bring proof to the civil surgeon. This helps avoid delays in your application.
Common Issues and How to Avoid Them
Submitting Form I-693 can sometimes lead to hiccups if you’re not careful. One common issue is failing to submit the form with your green card application (Form I-485). Since December 2, 2024, USCIS requires Form I-693 to be submitted simultaneously with Form I-485. If you don’t, your application might be rejected or delayed due to Requests for Evidence (RFEs).
Another frequent problem is incomplete or improperly filled forms. Make sure all sections are completed accurately and that the form is signed and sealed by the civil surgeon. Avoid submitting a form that is damaged, altered, or missing pages.
Finally, timing matters. Because medical exams signed after November 1, 2023, are valid indefinitely, it’s best to get your exam done close to when you file your application to avoid any questions about the form’s validity.
To avoid these issues, work with an experienced civil surgeon, double-check your paperwork, and submit all required documents together. This will help keep your application on track.
Frequently Asked Questions (FAQs)
When should I schedule my medical exam?
It’s best to schedule your medical exam shortly before or at the same time as you file your Form I-485, to ensure your Form I-693 is current and valid when submitted.
What if the medical exam finds a health issue?
If the civil surgeon identifies a condition that could make you inadmissible, they will provide guidance on treatment or follow-up. USCIS will review the case and may request additional information or waivers depending on the situation.
How long is Form I-693 valid?
Medical exams signed by civil surgeons after November 1, 2023, are valid indefinitely for USCIS purposes, so you don’t need to worry about expiration while your application is pending.
Can I submit Form I-693 after filing Form I-485?
No, since December 2, 2024, USCIS requires Form I-693 to be submitted together with Form I-485. Late submissions may cause your application to be rejected or delayed.
Conclusion
Form I-693 is a vital part of the U.S. immigration process, ensuring that applicants meet health and vaccination standards to protect themselves and the public. With recent policy updates, like the removal of the COVID-19 vaccine requirement, staying informed is more important than ever.
By understanding the medical exam process, vaccination requirements, and common pitfalls, you can confidently navigate this step without unnecessary delays. Remember to work with a designated civil surgeon, keep your records organized, and submit your forms correctly. Doing so will help you move closer to achieving your goal of becoming a lawful permanent resident in the United States.