What Is Form I-693 and Who Needs to Complete It? - GlobalDocuHub

Form I-693, the Report of Immigration Medical Examination and Vaccination Record, is the official document used by U.S. Citizenship and Immigration Services (USCIS) to determine whether a Green Card applicant meets the health-related admissibility requirements for lawful permanent residence. This form documents the results of your immigration medical examination, confirming that you do not have any communicable diseases of public health significance, that you have received all required vaccinations (or qualify for a waiver), and that you do not have drug abuse or addiction issues or a physical or mental disorder associated with harmful behavior.

Key Rule: Effective December 2, 2024, you must submit Form I-693 or a partial Form I-693 (such as the Vaccination Record) with your Form I-485. Otherwise, USCIS may reject your adjustment of status application. The form must be completed and signed by a USCIS-designated civil surgeon—your regular doctor cannot perform this exam even if they are a U.S.-licensed physician.

What Is Form I-693 Used For?

Form I-693 serves as the official medical record USCIS uses to evaluate your admissibility on health-related grounds. The civil surgeon documents the results of your physical examination, required laboratory tests, tuberculosis screening, and vaccination history.

Specifically, Form I-693 confirms that you:

• Do not have a Class A communicable disease of public health significance (such as active tuberculosis, syphilis, gonorrhea, or leprosy).
• Have received all required vaccinations according to CDC and ACIP guidelines, or qualify for a waiver.
• Do not have drug abuse or addiction issues.
• Do not have a physical or mental disorder associated with harmful behavior.

While USCIS does not charge a filing fee for Form I-693 itself, you will need to pay the civil surgeon for the examination and any required tests or vaccines.

Who Needs to Complete Form I-693?

You must submit Form I-693 if you are filing for lawful permanent residence (a Green Card) through adjustment of status from within the United States and you undergo a medical examination. Most applicants filing Form I-485 are required to submit this form.

However, there are exceptions. Some applicants may only need to submit a partial Form I-693 (Parts 1-5, Part 7, and Part 10, the Vaccination Record) rather than the full medical examination report. This includes:

• Refugees (Form I-590 or I-730) who already completed an immigration medical examination conducted by a panel physician outside the United States.
• Derivative asylees (Form I-730) who already completed an immigration medical examination abroad.
• K-1 fiancé(e) entrants who were already examined abroad and only need the vaccination record updated.

If you are a U.S. citizen applying for a Green Card, you do not need Form I-693.

Pro Tip: If you entered the U.S. on a K-1 visa and have a complete DS-3025 (Vaccination Documentation Worksheet) from your overseas exam, you may not need a full I-693—only the vaccination record portion may be required. Check the exceptions carefully before filing.

How to Complete and Submit Form I-693

Form I-693 involves a multi-step process that requires coordination between you and a USCIS-designated civil surgeon. Here is the complete workflow:

1. Find a USCIS-designated civil surgeon. Only these doctors are authorized to complete and sign Form I-693. Use the official USCIS Find a Civil Surgeon tool to locate one near you.
2. Gather your documents. Before your appointment, collect: vaccination records, a government-issued photo ID, prior test results, and any relevant medical records.
3. Fill out Parts 1 and 2 of Form I-693. You can complete the applicant information sections before your exam. Do not sign the form until the civil surgeon instructs you to do so.
4. Attend your medical examination. The civil surgeon will review your medical history, perform a physical exam, order required tests (TB screening, blood tests for syphilis, urine test for gonorrhea), and review your vaccination records.
5. Receive any required vaccines. The civil surgeon will administer any age-appropriate vaccines you are missing.
6. Sign the form in the presence of the civil surgeon. The surgeon will complete the remaining sections, sign the form, and place it in a sealed envelope.
7. Request a copy for your records. Before the envelope is sealed, ask for a copy of the completed Form I-693 for your personal files.
8. Submit the sealed envelope with your Form I-485. The submission method depends on how you file:
   • Mail filing: Submit the original sealed envelope with your Form I-485 application package. Do not open it—USCIS will reject an opened envelope.
   • Online filing: You must open the sealed envelope, upload the completed Form I-693 with your application, and keep the original form and envelope until USCIS makes a final decision.

Important: If you file Form I-485 by mail, the sealed envelope must remain unopened. If you file online, you must open it to upload the form—this is the only scenario where opening the envelope is permitted.

Costs, Fees, and Validity Rules

Understanding the costs and validity period of Form I-693 is essential for proper planning.

Cost Component	Estimated Range	Notes
USCIS filing fee for I-693	$0	No filing fee for this form
Civil surgeon examination fee	$100 – $500	Varies by location and provider
Vaccines (per dose, if needed)	$20 – $150 each	Depends on which vaccines you still need
TB blood test (IGRA)	$50 – $150	Required for applicants 2 and older
Syphilis test	$20 – $50	Required for certain age groups

Validity period: This is one of the most important rules to understand. Forms I-693 signed by a civil surgeon on or after November 1, 2023 are considered valid indefinitely while USCIS adjudicates your application. This means you do not need to worry about the exam expiring while your case is pending.

However, if your Form I-693 was signed before November 1, 2023, the older 2-year validity period still applies. Additionally, if the application with which the I-693 was submitted is withdrawn or denied, that Form I-693 is no longer valid.

Common Mistakes to Avoid

Even with the correct information, many applicants make errors that delay their cases. Avoid these common pitfalls:

• Using a non-designated doctor. Only USCIS-designated civil surgeons can complete Form I-693.
• Opening the sealed envelope for mail filings. If you file by mail, the envelope must remain sealed—opening it invalidates the exam.
• Filing Form I-485 without Form I-693. As of December 2024, this will result in rejection.
• Using an outdated form edition. USCIS only accepts the current edition. As of July 2025, the accepted edition is 01/20/2025.
• Not signing the form in the presence of the civil surgeon. An unsigned form is automatically rejected.
• Forgetting to bring vaccination records. Without proof of prior vaccinations, you will need to pay for and receive them during the exam.

Frequently Asked Questions

Q: What is Form I-693?
A: Form I-693 is the Report of Immigration Medical Examination and Vaccination Record. It is the official USCIS form used to document that a Green Card applicant meets the health-related admissibility requirements for lawful permanent residence.

Q: Who needs to complete Form I-693?
A: Anyone filing for a Green Card through adjustment of status (Form I-485) inside the United States must submit Form I-693. Refugees, asylees, and K-1 visa holders may only need to submit a partial Form I-693 (the vaccination record) under certain conditions.

Q: Can my regular doctor complete Form I-693?
A: No. Only a USCIS-designated civil surgeon is authorized to complete and sign Form I-693.

Q: How much does Form I-693 cost?
A: USCIS does not charge a filing fee for Form I-693. However, the civil surgeon charges for the examination, which typically ranges from $100 to $500, plus the cost of any required vaccines or lab tests.

Q: How long is Form I-693 valid?
A: Forms I-693 signed by a civil surgeon on or after November 1, 2023, are valid indefinitely while USCIS adjudicates your application. Forms signed before that date are generally valid for 2 years.

Q: Do I need to submit Form I-693 with my Form I-485?
A: Yes. Effective December 2, 2024, you must submit Form I-693 or a partial Form I-693 with your Form I-485. Otherwise, USCIS may reject your application.

Q: What happens if I open the sealed envelope from the civil surgeon?
A: If you file by mail, opening the envelope invalidates the exam, and USCIS will not accept the form. If you file online, you must open the envelope to upload the form, but you must keep the original for your records.

Q: What vaccines are required for Form I-693?
A: Vaccination requirements follow the CDC immunization schedule for immigration and ACIP recommendations. Common required vaccines include MMR, Tdap, polio, varicella, hepatitis B, and seasonal influenza. The COVID-19 vaccine is no longer required as of January 2025.