Form I-693 is the immigration medical report that a USCIS-designated doctor, called a civil surgeon, completes for people applying for a Green Card in the United States. USCIS says that if you file Form I-485 (Application to Register Permanent Residence or Adjust Status), you must submit Form I-693, or a partial form, with it. The rules on how long a completed I-693 stays usable have changed more than once, so check the official pages linked below before you rely on any date.
What Form I-693 is
USCIS describes Form I-693 as the report of your immigration medical examination and vaccination record. USCIS says applicants adjusting status use it to show they are not inadmissible on health-related grounds. In plain words, it is the paperwork that shows a doctor has checked the medical items USCIS requires.
Some applicants need only a partial form. USCIS lists certain refugees, derivative asylees, K-1/K-2/K-3/K-4 nonimmigrants, and Afghan nationals who arrived under Operation Allies Welcome as examples. If you think the partial form may apply to you, read the I-693 page and the form instructions, or ask a licensed immigration attorney.
Who can do the exam
Only a civil surgeon can complete the form for an adjustment applicant inside the United States. The USCIS Policy Manual says that a civil surgeon in the United States performs the medical examination for benefit applications processed inside the country, and its chart lists civil surgeons as the examiners for adjustment applicants, with some exceptions noted elsewhere in that chart. USCIS points people to its Find a Civil Surgeon page to locate a designated doctor.
USCIS also says it does not regulate the fees that civil surgeons charge for the exam. That means prices can differ from office to office. You can call more than one office and ask what the visit includes before you book.
The sealed envelope
The civil surgeon completes and signs the form and seals it in an envelope. USCIS tells its own staff: "Do not accept the Form I-693 if it is not in a sealed envelope." The applicant, not the civil surgeon, submits the form to USCIS.
- Mail filers send the form in the original sealed envelope.
- Online filers open the envelope and upload the form. USCIS says they must keep the original form and envelope until USCIS makes a final decision on the I-485.
When to submit it
USCIS says that effective December 2, 2024, you must submit Form I-693, or a partial Form I-693, with your Form I-485. The page adds: "Otherwise, we may reject your Form I-485." Because this requirement is recent, check the date on any older article you read.
How long is a completed I-693 valid?
This is the part that has changed the most, and USCIS pages show several dated updates. The I-693 page itself does not give a number of months. It refers readers to the Policy Manual, Volume 8, Part B, Chapter 4. As of the Policy Manual page we read, here is what USCIS says:
| When the civil surgeon signed | What USCIS says |
|---|---|
| On or after November 1, 2023 | The form can only be used as evidence that you are not inadmissible on health-related grounds, for the entire period the application it was submitted with is pending. If that application is withdrawn or denied, a new signed form is needed for any future application that requires it. |
| Before November 1, 2023 | The form keeps its evidentiary value for 2 years from the date of the civil surgeon's signature. |
A policy alert dated June 11, 2025 adds that the form "is generally valid only for the immigration benefit application for which it was submitted." The Policy Manual footnotes say that from April 4, 2024 until June 11, 2025, forms signed on or after November 1, 2023 were treated as valid indefinitely. The June 11, 2025 alert says its guidance is effective immediately and applies to requests pending or filed on or after that date.
The Policy Manual also says the old rule that the civil surgeon's signature had to be dated no more than 60 days before filing was permanently removed on March 31, 2023.
Because this policy has moved several times, treat the table as a snapshot. Read the Policy Manual chapter itself, and ask a licensed immigration attorney if you have an older form or a form tied to an earlier application.
Which edition of the form
USCIS says the current edition is dated 01/20/25. Forms signed on or before July 2, 2025 could use the 03/09/23 or 01/20/25 edition. USCIS says: "If the civil surgeon signs your form July 3, 2025 or later, USCIS will accept only the 01/20/25 edition."
If USCIS asks for more evidence
If a notice from USCIS mentions your medical exam, read it closely and note the response deadline. Our guide to what to do after a USCIS request for evidence explains how those notices work in general. For the I-485 itself, see our Form I-485 page.
Common questions
Can I send the I-693 after I file the I-485?
USCIS says that if you file Form I-485 you must submit Form I-693 or a partial form with it, and that otherwise it may reject the I-485. Check the I-693 page for the current wording before filing.
What if my envelope is not sealed?
USCIS instructs its staff not to accept an I-693 that is not in a sealed envelope. Mail filers should submit it in the original sealed envelope.
Does USCIS set the civil surgeon's fee?
No. USCIS says it does not regulate the fees civil surgeons charge for the immigration medical examination.
Does my old I-693 still count for a new application?
USCIS says a form is generally valid only for the application it was submitted with, and that a new signed form is needed for a future application if the earlier one was withdrawn or denied. Because forms signed at different times follow different rules, an attorney can look at your specific form and dates.
Official sources
- USCIS: Form I-693, Report of Immigration Medical Examination and Vaccination Record
- USCIS Policy Manual, Volume 8, Part B, Chapter 4 (Review of Medical Examination Documentation)
- USCIS Policy Manual, Volume 8, Part B, Chapter 3
- USCIS: Finding a Medical Doctor
- USCIS: Form I-485, Application to Register Permanent Residence or Adjust Status
GreenLight is not affiliated with USCIS or the U.S. government. This article is for informational purposes only and does not constitute legal advice.