Form I-693: What Green Card Applicants Need to Know About the Immigration Medical Exam
For anyone applying for a Green Card through adjustment of status inside the United States, the immigration medical examination is a required step — and the document that captures its results is Form I-693. Filing an I-693 — formally known as the Report of Immigration Medical Examination and Vaccination Record — is how applicants demonstrate to U.S. Citizenship and Immigration Services (USCIS) that they meet the health-related standards required for permanent residency. Understanding what the form requires, how the process works, and where mistakes commonly occur can help applicants avoid unnecessary delays.
What Form I-693 does
Form I-693 documents that a Green Card applicant does not have any health conditions that would render them inadmissible to the United States on public health grounds. Specifically, it 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.
The form is not completed by the applicant alone. While certain sections may be filled in before the medical exam, the substantive portions of Form I-693 are completed and signed by a USCIS-designated civil surgeon — the only type of physician authorized to conduct immigration medical examinations for adjustment of status applicants inside the United States.
Who needs to file it
Form I-693 is required for individuals applying for lawful permanent residence through adjustment of status from within the United States. Refugees and certain asylum applicants who need to provide proof of a medical examination also use this form.
Applicants applying for a Green Card from outside the United States follow a different process. In those cases, a panel physician — rather than a civil surgeon — conducts the examination and submits a separate medical form to the Department of State. The local U.S. embassy or consulate can provide guidance on scheduling an appointment with an approved panel physician.
How to complete and submit Form I-693
The process for completing Form I-693 involves several steps that must be followed in a specific order.
- Gather relevant medical records before the appointment. This includes vaccination records, a government-issued photo identification, and any records of past or ongoing medical treatment that may be relevant.
- Complete the applicant-facing sections of the form. Part 1 (personal information) and Part 2 (contact information and signature) may be filled out before the exam. Importantly, the form should not be signed until the civil surgeon instructs the applicant to do so. Sections beyond these parts should be left blank — the civil surgeon will complete the remainder after the examination.
- Schedule an appointment with a USCIS-designated civil surgeon. Only civil surgeons who appear in the official USCIS civil surgeon search tool are authorized to complete Form I-693. Applicants should confirm the physician’s current designation status before scheduling.
- Attend the medical examination. The civil surgeon will conduct a physical examination, review vaccination records, administer any required vaccinations, complete all medical findings on the form, and sign and date it.
- Do not open the sealed envelope. Once the civil surgeon has completed the form, it is placed in a sealed envelope. USCIS will reject Form I-693 if the seal is 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 packet. The sealed envelope should be included with the filing without being opened.
Common mistakes that cause delays
USCIS may issue a Request for Evidence if Form I-693 is found to be incomplete or improperly prepared — a complication that can add months to a Green Card application. Errors frequently cited as causes of delays include:
- Using an outdated version of the form. USCIS periodically updates its forms, and submitting an older version can result in rejection.
- Signing the form before the civil surgeon instructs the applicant to do so. The civil surgeon must be present when the form is signed.
- Opening the sealed envelope. A broken seal will result in rejection of the form.
- Failing to bring vaccination records to the appointment. Missing vaccination documentation can require follow-up appointments and delay completion of the form.
- Using ink other than black. USCIS requires black ink for all handwritten entries on the form.
Costs
There is no USCIS filing fee for Form I-693 itself. The cost of the medical examination varies depending on the civil surgeon, the tests required, and any vaccinations that need to be administered. Costs frequently range between $150 and $500. Health insurance may cover some or all 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, Form I-693 is a straightforward part of the adjustment of status process. However, for individuals with medical conditions 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 greater confidence.
