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I-693 Form – Immigration Medical Exam – Complete Guide

I-693 Form – Immigration Medical Exam – Complete Guide

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Last updated: April 2, 2024.

By Asel Mukambetova, Esq. · Columbia Law School · Licensed immigration attorney

You are required to submit Form I-693 (Immigration Medical Exam) with your green card application. Learn how to find a USCIS approved doctor, when to prepare and file the form and other rules in our guide.

Under U.S. immigration law, every foreign national who applies for immigration through Form I-485 (Application for Adjustment of Status) or Form DS-260 (Immigrant Visa and Alien Registration Application), must undergo an immigration medical examination.

In collaboration with the U.S. Department of Health and Human Services (HHS) and the U.S. Centers for Disease Control and Prevention (CDC), the United States Citizenship and Immigration Services (USCIS) has established medical exam and immunization protocols to assure foreign-born aliens seeking admission and immigration to the U.S. do not pose a health risk to the citizens of the United States.

Form I-693 (Report of Medical Examination and Vaccination) is used to report the results of these immigration exams to the USCIS.

This article discusses Form I-693:

  • What is Form I-693?
  • Who Must Submit Form I-693?
  • What is the Medical Examination Process?
  • What are Form I-693 Fees?
  • When to Submit Form I-693?
  • Who Can Be Denied Immigration on Health-Related Grounds?

Form I-693 – What is Immigration Medical Exam?

Form I-693 reports the results of all medical examinations required by U.S. law to USCIS.

The results of your medical examination are confidential.

USCIS uses them only for immigration purposes.

Doctors who performed the examination may share the results with other U.S. agencies for the protection of public health.

A USCIS official cannot discuss your medical issues with other people.

Form I-693- Who Needs to File?

Any foreign-born non-citizen seeking immigration to the U. S. must file Form I-693 with the USCIS. All family-based and employment-based immigrants are required to submit a sealed medical Form I-693 with their immigration applications.

Form I-693 – Medical Exam Process

If you do not properly follow all instructions in submitting your I-693 form, you will be required to undergo a new medical exam at your expense.

This will cause a delay in the processing of your immigration application.

While USCIS does not charge a fee for processing Form I-693, you are responsible to pay for your own medical exam.

Because USCIS does not regulate USCIS approved doctors, the cost of your medical examination will vary depending on your doctor and location.

How to Find a USCIS Approved Doctor (“Civil Surgeon”) in Your Area

USCIS doctors are known as “civil surgeons” under immigration law.

The USCIS will only accept Form I-693 if it is completed by a USCIS approved civil surgeon.

If you are in the United States, find a doctor in your area by using the “Find a Doctor” tool on the USCIS website at: Find a doctor

If you are located abroad and need to complete the medical examination prior to your immigrant visa interview at the U.S. Embassy or Consulate, learn more in our Medical Examination for Immigrant Visa Applicants guide.

When to Schedule Your I-693 Form Immigration Medical Examination?

It’s recommended to complete Form I-693 as close as possible to your Form I-485 application time.

Signed Forms I-693 are valid for 2 years after a civil surgeon signs it.

Most applicants get their Form I-485 applications processed within 2 years, so the medical form usually is still valid at the time an USCIS officer is reviewing your green card application.

If you are seeking to adjust your status under Form I-485, you have three ways to file Form I-693:

  • By mail, at the same time you file your I-485 application (recommended);
  • By mail, after USCIS issued a Request for Evidence (RFE) in response to your missing Form I-693 (strictly follow the mailing instructions provided on the RFE notice); or
  • By hand-delivering, on the date of your immigration interview (if you will have an interview scheduled at your local USCIS office).

If you are applying for an immigrant visa from abroad, the National Visa Center (NVC) directs you not to schedule your exam until you receive your NVC letter stating your immigration interview has been scheduled.

This letter will also tell you to bring your completed medical form with you to the interview at the U.S. Embassy or Consulate.

Because you have to bring your medical examination results to the interview with you, it’s important that you make your immigration medical exam appointment as soon as you receive NVC’s letter.

Depending on your doctor and location, it might take one or two weeks to get an appointment and another week or two for all medical tests to return from the laboratory.

Learn more about scheduling medical examinations outside the U.S. (if you are applying for Consular Processing): Medical Examination for Immigrant Visa Applicants

What You Should Bring to Your I -693 Form Medical Examination?

USCIS is constantly updating Form I-693, and USCIS instructs you to use the latest version of I-693.

A day or two prior to your immigration medical exam appointment, print the latest version of Form I-693 on USCIS website at: https://www.uscis.gov/i-693

You should bring the following documents to your medical exam:

  • Form I-693 (the latest version);
  • Proof of all vaccinations (since birth until present, photocopies are accepted, provide all available vaccination records);
  • A government-issued photo ID (state ID, state-issued driver license, passport, work permit; travel permit, etc.);
  • A method of payment for your medical examination (civil surgeons typically charge $200-$600 for a medical examination, check with the doctor before your appointment to see your exam cost and how to pay); and
  • If you are applying for an immigrant visa outside the U.S., you must bring your NVC interview-scheduling letter.

How to Complete I-693 Form

Form I-693 is divided into 11 parts.

Typically, the medical office staff prepares your Form I-693. 

You must complete Part 1 (Information About You).

Do not sign Form I-693 until your civil surgeon tells you to.

It is your doctor’s office responsibility to complete the rest of Form I-693. 

Request a photocopy of your completed Form I-693 for your records. Do not open a sealed medical form. It can be opened by USCIS only.

I-693 Form Processing Time

How long it takes of prepare Form I-693 is dependent upon a number of factors, including:

  • If you miss any required vaccinations. Some vaccinations are completed in 2 doses with intervals, so it can take you about 1-1.5 months to receive the missing vaccinations;
  • The vaccination records you bring with you to your immigration exam;
  • How long it takes for any blood, urine, or other tests to be returned from the laboratory and reviewed by your doctor;
  • Whether or not the doctor orders any follow-up exams or testing; and/or
  • Medical office’s turnaround time.

I-693 Form Fees

There is no government filing fee for the processing of Form I-693.

Your only cost is your medical examination fee which you pay directly to the medical office you chose.

The fees you’ll pay for your medical exam varies widely depending on your doctor and location. In general, it costs anywhere between $200 to $600 to complete a medical examination in the U.S.

You might also pay additional fees for any missing vaccinations.

You can ask the civil surgeon about any medical exam fees at the time you schedule your appointment.

If that doctor’s fees seem excessive, try to schedule an appointment with a different civil surgeon.

When to Submit I-693 Form?

If you are applying for an immigrant visa through Form DS-260, the National Visa Center instructs you not to schedule your medical exam until after you receive your NVC letter notifying you that your immigration interview is scheduled.

NVC will also instruct you to bring your medical examination results with you to your immigration interview.

If you are applying for adjustment of status through Form I-485, submit your completed I-693 form at the same time you file Form I-485.

Your I-693 medical exam is valid for two years.

If your medical form expires prior to Form I-485 approval, USCIS will issue an RFE notice (Request for Evidence) and instruct you to submit a new medical form.

You will need to contact the civil surgeon’s office and schedule an appointment.

You might be required to pay an additional fee to obtain a new sealed Form I-693. 

What to Expect During Your Immigration Medical Examination?

Your USCIS medical exam is not like a routine physical you receive from your physician.

During your examination, the civil surgeon will conduct a complete medical history.

You will be asked both general and specific questions about your health, including what immunizations and vaccines you’ve had in the past.

You will also undergo a complete physical exam that will include drawing of blood and urine.

The civil surgeon may order more medical tests.

During your exam, the civil surgeon will look for any medical conditions that may influence your right to immigration:

  • Communicable diseases (tuberculosis, syphilis, gonorrhea, etc.);
  • Drug abuse or addiction;
  • Physical or mental disorders that may result in aggressive behavior; and
  • Physical or mental disorders that may result in you being unable to support yourself.

Under U.S. law, all foreign nationals who applied for immigration are required to receive vaccinations to prevent the following diseases:

  • Mumps;
  • Measles;
  • Rubella;
  • Polio;
  • Tetanus and Diphtheria Toxoids;
  • Pertussis (Whooping Cough);
  • Haemophilus influenza type B;
  • Hepatitis B; and/or
  • Any other vaccine-preventable diseases recommended by the HHS and CDC;
  • COVID-19.

You can find the full list of required vaccinations based on applicant’s age here.

IMPORTANT: Be sure to ask for a photocopy of your completed I-693 form after your doctor has completed and signed it.

Keep this copy in a safe place for your records.

Under immigration law, once your civil surgeon completes Form I-693, the doctor will place it in an envelope and seal it.

Your civil surgeon will give the sealed envelope back to you to give to USCIS.

It is your responsibility to deliver the completed sealed firm to USCIS.

IMPORTANT: Do not open, tamper, or otherwise break the seal of the envelope.

If USCIS detects any evidence that the seal was tampered with, USCIS will reject your form and you will be required to undergo a new immigration examination at your expense.

This will cause a delay in the processing of your immigration application. 

Who Can Be Denied a Green Card on Health-Related Grounds?

You can be denied a green card for a variety of health-related reasons:

Communicable Diseases

If you have any type of active, untreated, communicable gonorrhea, leprosy, syphilis, or tuberculosis, you will be denied a green card until the disease has been treated and/or cured.

Drug and Alcohol Abuse

If you have a drug and/or alcohol abuse problem or history, you might be asked to take a drug or alcohol test and/or prove that you have completed a drug or alcohol treatment program.

If you are abusing drugs or alcohol, you will be denied a green card.

Mental Illness with a History of Threat or Violence

If you have a mental illness associated with violence against oneself or others, you will have trouble getting a green card.

Under immigration policy, drunk driving falls within this category.

Related Links:

Adjustment of Status Process

Consular Processing – How to Apply for Immigrant Visa

Medical Examination for Immigrant Visa Applicants

How to Fill Out Form I-485

Form I-485 Checklist of Required Documents