Form I-693 is the medical exam report that USCIS requires from most green card applicants through adjustment of status. The exam is performed by a USCIS-designated doctor, the civil surgeon, and the applicant is the one who submits the result to USCIS, in a sealed envelope. In this guide you'll see who fills out what, what to bring, and the steps the official source describes.
What Is Form I-693?
According to the official I-693 page, the form is used "to report the results of a medical examination to USCIS." The exam exists to establish that the applicant is not inadmissible to the United States for public health reasons.
The full name is Report of Medical Examination and Vaccination Record, meaning that in addition to the exam, the form also serves as a vaccination record. The USCIS Policy Manual explains that failure to show proof of the required vaccinations for those seeking adjustment of status is one of the conditions included in this public health analysis.
Who Needs to Submit Form I-693?
The USCIS page states that most applicants for permanent resident status through adjustment of status submit Form I-693, completed by a civil surgeon. The form instructions add that each applicant needs their own I-693, so a family filing together uses one form per person.
The instructions also note that refugees, some K and V visa holders, and dependents of asylees may have different rules, depending on whether they had the exam abroad. Those applying for an immigrant visa through the Department of State don't use a civil surgeon: the USCIS page on finding a doctor states that this group consults a panel physician abroad.
How Do You Find a Civil Surgeon?
The exam is only valid if performed by a designated physician. USCIS points to the "Find a Civil Surgeon" tool on myUSCIS and the contact center phone number, 800-375-5283, according to the official page. Civil surgeons are located within the United States.
Regarding costs, USCIS is direct: the agency does not regulate the amount civil surgeons charge. Prices vary by doctor, many offices don't accept health insurance, and insurance may not cover all parts of the exam. The same page suggests calling several offices and asking for an estimate before scheduling.
What Should You Bring to the Exam?
The USCIS page and the form instructions list the following items:
- A printed copy of the most recent I-693 with Part 1 completed. The official guidance is not to sign until the civil surgeon tells you to: "Complete Part 1 of Form I-693 but do not sign the form until the civil surgeon tells you to."
- A government-issued photo ID, such as a valid passport or driver's license. For children under 14, the instructions call for a document with name, date and place of birth, and parents' names, such as a birth certificate.
- Medical records, including the vaccination card.
The instructions state that vaccinations can be given during the exam or by a family doctor, and that the official record is Part 10 of the form.
What Does the Civil Surgeon Do During the Exam?
According to the I-693 instructions, the civil surgeon verifies identity and records the document presented, performs the exam following HHS regulations and CDC Technical Instructions, and refers the applicant for follow-up when a result requires it, such as a suspicious chest X-ray, which is referred to the local health department.
The exams described in the instructions include:
- tuberculosis testing for everyone age 2 and older;
- blood test for syphilis and gonorrhea testing for those age 15 and older;
- evaluation for Hansen's disease and other sexually transmitted infections.
The doctor only signs Part 7 once all follow-up is complete. For this reason, the exam may require more than one visit, and the applicant pays the office directly for all costs, including follow-up tests.
Why Does the Sealed Envelope Matter?
This rule is emphasized in the official source. The USCIS page states that the civil surgeon must deliver the form in a sealed envelope and that the applicant should not accept the document outside of it: "Do not accept it if it is not in a sealed envelope." If the envelope arrives open, torn, or altered, USCIS returns the form.
The instructions specify that the doctor writes "DO NOT OPEN. FOR USCIS USE ONLY." on the envelope, initials the flap, and seals it with clear tape. In practice, you check the envelope while still at the doctor's office and submit it to USCIS without opening it.
How and When Does the I-693 Reach USCIS?
The responsibility for submitting the form falls on the applicant, not the doctor. For those applying for adjustment of status, the USCIS page states that the I-693 accompanies Form I-485. Other categories follow the instructions of the USCIS office that requested the exam. If USCIS requests additional documents afterward, the guide on USCIS RFEs shows how the deadline works.
Regarding the validity period of the exam, USCIS updated the Policy Manual on the period during which an I-693 can be used, and the usage deadline for the exam has its own rules. Because of this, check the current rule on the official I-693 page and in the Policy Manual chapter before scheduling the appointment.
How Much Does the I-693 Cost at USCIS?
USCIS does not charge a filing fee for Form I-693: the official page lists a fee of $0. The actual cost lies with the civil surgeon's office, the tests, and the vaccinations, and that amount is set by each doctor.
What About the Rest of the Process?
The I-693 is one piece of the adjustment of status package. To see the full picture, read the guide on Form I-485: Steps, Evidence, and What USCIS Requests, the step-by-step guide on USCIS Biometrics, and the 5 Phases of the Family Green Card. Those going through the consulate should read the guide on DS-260, NVC, and the Consular Interview, where the exam is done abroad. Other topics are available on the Prime blog.
Prime Immigration Office prepares and organizes the paperwork the form requires. The exam itself, the result, and what it means are matters for the civil surgeon and USCIS.
Sources
- USCIS: Form I-693, Report of Medical Examination and Vaccination Record
- USCIS: Finding a Civil Surgeon
- USCIS: Form I-693 Instructions
- USCIS Policy Manual, Volume 8, Part B, Chapter 2
Educational information, not legal advice. Prime Immigration Office is a paralegal service — document preparation only. For legal advice, consult a licensed Texas attorney or DOJ-accredited representative.