I‑693 Medical Exam Explained: Why It Matters and What to Expect

Applying for a green card is a major milestone, and the Form I‑693 medical exam is one step you can’t afford to overlook. Designed to protect public health, this exam confirms that you meet the medical requirements set by U.S. immigration authorities. It’s more than just a check-up; it’s a key piece of your application that must be completed correctly and on time to avoid setbacks. In this blog, we’ll walk you through what the I‑693 exam involves, why it matters, and what to expect.

What Is the I‑693 Medical Exam?

The I‑693 medical exam, officially known as the Report of Medical Examination and Vaccination Record, is a health screening mandated by U.S. Citizenship and Immigration Services (USCIS). Its primary purpose is to confirm that applicants are not inadmissible on public health grounds, such as certain communicable diseases or lack of required vaccinations.

This exam must be conducted by a USCIS-designated civil surgeon, and it is required for anyone applying for an adjustment of status (green card) from within the United States.

Why Is the I‑693 Exam Important?

The I‑693 medical exam is a mandatory part of your green card application. Failure to complete the exam, or submitting an incomplete or expired form can lead to delays, Requests for Evidence (RFEs), or even denial of your case.

What makes it so crucial:

• The completed medical exam form I‑693 must be submitted in a sealed envelope directly to USCIS.
• Once signed by the civil surgeon, the form is valid indefinitely, as long as the original seal remains intact
• USCIS will not accept an I‑693 form that is opened, altered, damaged, or expired.

What to Bring to the I‑693 Medical Examination

Bring the following items to ensure your exam can be completed without unnecessary delays:

• A government-issued photo ID (such as a passport, driver’s license, or national ID card)
• A copy of your immunization or vaccination records if available
• Any prior TB test results, TB treatment records, and chest X-ray reports
• A list of current medications and any relevant medical history, especially chronic conditions

Tip: If you have questions about required vaccinations, you can review CDC guidelines or ask the civil surgeon during your visit.

What to Expect During the I‑693 Medical Exam

While the process can vary slightly depending on your health status and clinic policies, here’s what typically happens during your appointment:

1. Physical Examination: A general health check-up to assess your overall physical condition.

2. Required Testing:

• Tuberculosis (TB) testing: Usually a blood test (IGRA); follow-up chest X-ray may be required if results are positive
• Blood test for syphilis (for applicants aged 18 - 44)
• Urine test for gonorrhea (for applicants aged 18–24)

3. Vaccination Review and Administration: The civil surgeon will review your vaccination records and administer or order any missing vaccines required by USCIS guidelines. These may include MMR, Tdap, varicella, influenza (seasonal), and others based on age.

4. Follow-Up Instructions: You may be asked to return for follow-up lab results or additional vaccinations. Once complete, the civil surgeon will seal your I‑693 form in an official envelope for USCIS submission.

Choosing the Right USCIS I‑693 Doctor

It’s important to understand that not all doctors can perform immigration medical exams. The exam must be completed by a USCIS-designated civil surgeon.

• Civil surgeons receive special training and are certified by USCIS
• They ensure all required tests and documentation are completed accurately
• They stay up to date on CDC vaccination guidelines and USCIS policy changes
• They will ensure your I‑693 is properly sealed and ready for submission

Conclusion 

Form I‑693 is an important part of the green card application process. Submitting it accurately and on time helps ensure your case moves forward without unnecessary delays. Mistakes or missing information can lead to extra steps, requests for evidence, and other setbacks in your immigration journey. That’s why it’s helpful to work with a USCIS-designated civil surgeon who understands the process and is committed to supporting you every step of the way.

Schedule an appointment with our expert & experienced civil surgeon, Dr. Steven Wittenberg Gordon to make the immigration medical exam process clear, efficient, and stress-free.