Form I-693: The Immigration Medical Exam Explained for Green Card Applicants
The path to a Green Card involves many forms and steps, but few are as procedurally specific as the medical examination. Form I-693, the Report of Immigration Medical Examination and Vaccination Record, is how applicants document that they meet the health-related standards required for permanent residency in the United States.
Unlike most immigration forms, it cannot be completed entirely by the applicant — a USCIS-designated civil surgeon must conduct the examination and complete the substantive portions. Knowing what to expect, what to bring, and what mistakes to avoid can help applicants move through this step without unnecessary delays.
What Form I-693 establishes
When applying for lawful permanent residence, U.S. immigration law requires that applicants meet specific health-related grounds of admissibility. Form I-693 is the official document that confirms an applicant has undergone the required examination and does not have conditions that would render them inadmissible on public health grounds.
Specifically, the form confirms that the applicant does not have a Class A communicable disease of public health significance, is current on required vaccinations or qualifies for a waiver, does not have drug abuse or addiction issues, and does not have a physical or mental disorder associated with harmful behavior.
Who needs to file it
Form I-693 is required for individuals applying for a Green Card through adjustment of status from within the United States. Refugees and certain asylum applicants who need to document a medical examination also use this form.
Applicants pursuing a Green Card through consular processing from outside the United States follow a different process. In those cases, a panel physician — not a civil surgeon — conducts the examination and submits results using a separate form to the Department of State. The local U.S. embassy or consulate can assist with identifying an approved panel physician.
How to complete and submit Form I-693
The process for Form I-693 must follow a specific sequence. Deviating from it — even in minor ways — can result in a Request for Evidence that delays the entire Green Card application.
• Before the appointment. Gather vaccination records, a government-issued photo identification, and any relevant medical records. The applicant may complete Part 1 (personal information) and Part 2 (contact information) of the form in advance, but should not sign the form until the civil surgeon instructs them to do so. All other sections must be left blank for the civil surgeon to complete.
• Find a USCIS-designated civil surgeon. Only civil surgeons authorized by USCIS may conduct immigration medical examinations for adjustment of status applicants. A current list is available through the USCIS civil surgeon search tool. Applicants should confirm the physician’s current designation status before scheduling.
• Attend the examination. The civil surgeon conducts a physical examination, reviews vaccination records, administers any required vaccinations, completes the medical findings on the form, and signs and dates it.
• Do not open the sealed envelope. Once completed, the civil surgeon places Form I-693 in a sealed envelope. USCIS will reject the form if the seal has been broken. A copy may be provided for the applicant’s own records.
Form I-693 is typically submitted to USCIS as part of the Form I-485 adjustment of status filing packet, with the sealed envelope included as-is.
Common mistakes that cause delays
Several errors are frequently cited as causes of processing delays or Requests for Evidence related to Form I-693:
• Using an outdated version of the form. USCIS updates its forms periodically — always use the current version downloaded from the USCIS website.
• Signing before being instructed to. The civil surgeon must be present when the form is signed. Signing in advance is grounds for rejection.
• Opening the sealed envelope. A broken seal results in automatic rejection of the form.
• Failing to bring vaccination records to the appointment. Missing immunization documentation can require follow-up appointments and delay the civil surgeon’s ability to complete the form.
• Using ink other than black. USCIS requires black ink for all handwritten entries on the form.
Cost
There is no USCIS filing fee for Form I-693 itself. The cost of the medical examination varies by civil surgeon and depends on which tests and vaccinations are required. Costs frequently range between $150 and $500. Health insurance may cover some portion of these costs depending on the plan and whether the civil surgeon participates in the applicant’s network.
The value of legal guidance
For most applicants, the Form I-693 process is straightforward when the steps are followed correctly. However, for individuals with medical histories that may raise questions about admissibility, consulting with experienced immigration counsel before the examination is a practice frequently cited as a prudent step — one that allows applicants to understand their options and approach the process with confidence.
