All About USCIS Form I-693: Report of Medical Examination and Vaccination Record

Meeting Green Card Eligibility With USCIS Form I-693

Immigrants hoping to enter the United States must meet specific public health criteria to receive a green card. Applicants filing an Application to Register Permanent Residence or Adjust Status (Form I-485) will also need to file a Report of Medical Examination and Vaccination Record (Form I-693). 

All green card applicants are subject to public health grounds of inadmissibility. As a green card applicant, you must prove that you don’t have a medical condition that would make you inadmissible on health-related grounds. 

Form I-693 shows that an applicant does not have a Class A medical condition and has met vaccination requirements or has received a waiver. A Form I-693 stating that you have a “Class A condition” is conclusive evidence of inadmissibility. This means that you won’t be able to enter the United States.

What Are Class A Medical Conditions?

A Class A medical condition is:

• Any communicable disease of public health significance according to the U.S. Department of Health and Human Services (HHS), including gonorrhea, Hansen's disease (infectious), syphilis (infectious), and tuberculosis (active)

• A present or past physical or mental disorder with associated harmful behavior or harmful behavior that is likely to recur

• Drug addiction or drug abuse

If you don’t have documentation that proves you’ve received certain required vaccines and immunizations, this is also considered a Class A medical condition. This includes vaccinations for COVID-19, hepatitis-a, hepatitis-b, rubella, leprosy, meningococcal, mumps, varicella, and diphtheria. 

The Public Health Criteria

A USCIS-designated civil surgeon (doctor) must perform your medical examination. These exams are guided by U.S. Department of Health and Human Services (HHS) regulations. Both you and the civil surgeon must complete the designated section on Form I-693. 

Keep in mind the following timeframes for your application:

• You have 60 days from the date the civil surgeon signed your Form I-693 to file Form I-485 with USCIS.

• The USCIS will issue a decision on the application within two years of the date the civil surgeon signed Form I-693.

If you fail to meet any of the public health criteria, your application for admission to the United States is at risk. However, there is still hope for approval. The hearing officer in charge of your application may also issue a Request for Evidence (RFE) or Notice of Intent to Deny (NOID). In this case, the officer may ask you to take additional medical tests, which may shed a more positive light on your medical condition, allowing you to legally enter the United States.   

Medical conditions can change. Even if you meet all the public health criteria on your initial Form I-693, the officer is allowed to ask you to submit a new Form I-693. 

Who Is Exempt From Filing USCIS Form I-693?

Not everyone applying for a green card or adjustment of status is required to get a medical exam and file Form I-693. If you receive a grant of asylum, you are not required to apply for a green card for a year, which means you are exempt from completing Form I-693 for one year. In some cases, refugee applicants and individuals filing for an adjustment of status are exempt from filing this form.

Are Refugees Exempt From Filing Form I-693?

Panel physicians perform overseas medical exams at the direction of a U.S. embassy or consulate where you live. Civil surgeons perform medical examinations that occur in the United States.

If you are a refugee applicant and you have received an overseas medical exam from a panel physician who found no Class A medical conditions, you only need to meet the vaccination requirements to gain legal entry into the United States. In this case, you only need to complete Part 10 of Form I-693, which is the vaccination record. 

If the panel physician did find a Class A condition during the overseas exam, you must complete Form I-693 in its entirety, which means taking an immigration medical exam. An alternative is filing an Application for Waiver of Grounds of Inadmissibility (Form I-690). Applicants may use this form to waive the vaccination requirements due to moral convictions or religious beliefs.

If You Are Applying for an Adjustment of Status, Do You Need a Medical Exam?

Some immigrants who are applying for an adjustment of status have already received a medical exam before entering the U.S. These applicants are exempt from filing Form I-693. If this applies to you, you only need to file Form I-485: Application to Register Permanent Residence or Adjust Status. However, you must file your application to adjust status within one year of your initial medical examination. 

This requirement applies to:

• K-1 fiancé(e) visa holders

• K-2 visa holders (children of a K-1 fiancé(e) visa holder)

• K-3 visa holders (foreign spouses of U.S. citizens)

• K-4 visa holders (children of K-3 spouse visa holders)

• V-1 visa holders (spouse)

• V-2 visa holders (children of a V-1 spouse)

• V-3 visa holders (children of unmarried V-2 holders)

How To Find a Doctor To Complete USCIS Form I-693

A doctor who gives examinations in the U.S. is known as a "civil surgeon." The USCIS website provides a list of civil surgeons on its Find a Doctor page. You can also call the USCIS Contact Center at 1-800-375-5283. The civil surgeon completes Form I-693 to report exam results. You will receive your results in a sealed envelope. Do not open the sealed envelope. If you do, it immediately invalidates the results of the exam.

A doctor who gives exams overseas is known as a "panel physician." These doctors are appointed by a U.S. embassy or consulate. Visit the U.S. State Department FAQs for more information. Panel physicians use Form DS-2054 to report exam results.

Civil surgeons and panel physicians who conduct immigration medical examinations follow technical instructions from the Centers for Disease Control and Prevention (CDC).

How To Submit USCIS Form I-693

Upon completion of the examination, submit Form I-693 with your contact information with the civil surgeon’s signature in a sealed envelope 

Applicants can submit Form I-693 to USCIS with their immigration application or at any time after applying. However, this form must be filed before a final decision is made by USCIS. You can also bring the form to your green card interview or wait until USCIS issues a Request for Evidence (RFE) requesting the medical examination report. 

How Long Does Processing Take?

Five USCIS service centers process applications. The processing time of an application depends on the type of application. It also depends on the wait time at the service center processing the application. I-693 applications are usually filed with I-485 applications. These green card applications involving immediate relatives or spouses of a U.S. citizen take about 10 months to process.   

How Much Does It Cost To File USCIS Form I-693?

There is no filing fee to submit Form I-693. However, you must pay the physician for the exam. You may be able to save money by planning ahead and comparing the costs of different doctors in your area. The cost of these exams typically ranges from $150 to $500, but it should not be difficult to find an exam in the $200 range.