Form I-693, Report of Medical Examination and Vaccination Record, is the medical report USCIS requires from most people applying for a green card from inside the United States.
A USCIS-designated doctor, called a civil surgeon, performs the examination, completes the form, and seals it in an envelope you file with your green card application.
Beyond Border attorneys have collectively handled 4,000+ immigration cases across O-1, L-1, EB-1, and EB-2 NIW categories. The guidance below reflects USCIS and CDC sources verified as of September 2026.
Form I-693 is the result of an immigration medical examination for USCIS. It establishes that you are admissible to the United States on public health grounds.
Generally, everyone filing Form I-485 to adjust status to lawful permanent resident must submit a Form I-693 completed by a designated civil surgeon. That includes employment-based applicants in every category, and it includes each derivative family member filing alongside you.
The form does not assess whether you are healthy enough to live in the United States. It is a check against four specific grounds of inadmissibility, and most findings a doctor makes have no effect on your case at all.
Note: Form I-693 is filed inside the United States. If you are pursuing an immigrant visa through a consulate abroad, a Department of State panel physician examines you under a different procedure, and you do not file Form I-693 at all.
Only a civil surgeon, a physician specifically designated by USCIS to perform immigration medical examinations, may complete Form I-693 inside the United States. Your own primary care physician cannot do it unless they have that designation, and no amount of documentation from a non-designated doctor substitutes for it.
You can find a civil surgeon through the USCIS official locator list. You can search by ZIP code, then call two or three offices before booking. Here is what to ask.
When the examination is complete, the civil surgeon gives you the finished Form I-693 in a sealed envelope. Do not accept it if it is open, and do not open it. USCIS does not accept open forms and will ask you to retake the examination. You are responsible for submitting the form to USCIS.
Review your copy carefully before sealing the envelope. Your name, date of birth, and A-number must match your other filings exactly. If there’s a mismatch, you will have to retake the exam.
The examination has four components, set by the CDC's Technical Instructions for Civil Surgeons. The civil surgeon works through all four and records the results on the form.
Book your appointment at least six weeks before you intend to file. This allows time for lab results, a possible chest X-ray, and any vaccine doses you may need.
The vaccination assessment covers 15 vaccine-preventable diseases. Which ones apply to you depends on your age, following the age-by-age table in the CDC's Vaccination Technical Instructions for Civil Surgeons.
For adult applicants, the diseases commonly assessed are
The civil surgeon reviews the vaccination records you bring, records your history on the form, and administers any doses you need and consent to.
COVID-19 vaccination is no longer required. The CDC removed COVID-19 from the Technical Instructions for Civil Surgeons. USCIS also stopped requiring documentation from adjustment-of-status applicants as of January 20, 2025. USCIS has stated it will not issue Requests for Evidence or denials based on missing COVID-19 vaccination documentation.
The CDC separately removed the requirement for panel physicians, who examine consular applicants abroad, effective March 11, 2025. The requirement is that you be immunized, not that you be vaccinated at the appointment.
“Documented immunity counts, which is why the single most useful thing you can do before your appointment is assemble every vaccination record you hold, including childhood records and records from your home country. If you can show clear documentation of previous vaccinations, you do not have to repeat them,” Camila Facanha, Head of Legal Team at Beyond Border, adds.
USCIS does not set a filing fee for the Form I-693. But civil surgeons can charge a fee. USCIS also does not regulate the fees civil surgeons charge, and those fees vary by physician. Everything you pay goes to a private medical practice at a price it sets.
On average, this includes:
As of September 2026, a Form I-693 signed by a civil surgeon on or after November 1, 2023, is valid only while the application it was submitted with is pending. If you withdraw or USCIS denies that application, the Form I-693 is no longer valid, and any future application requires a newly completed form signed by a civil surgeon.
You must file your Form I-693 together with your Form I-485. Otherwise, USCIS may reject your Form I-485. Work backwards from the filing date you want. Book the civil surgeon at least six weeks in advance, allow time for lab results and any chest X-ray, and include the sealed envelope with your petition. Our Form I-485 documents checklist explains what else you need in the package, and our Form I-485 processing time analysis covers the analysis time.
A Class A condition makes an applicant inadmissible on health-related grounds. According to the USCIS Policy Manual, this includes four main categories: a communicable disease of public health significance, missing required vaccinations, a physical or mental disorder tied to harmful behavior, or drug abuse or addiction.
A Class B condition is a health finding significant enough to record but which does not by itself make you inadmissible. Most findings a civil surgeon makes fall outside both categories entirely.
Mental health screening focuses on whether a disorder causes harmful behavior, not simply having a diagnosis or past treatment. Even if harmful behavior occurred in the past, what matters is whether it is likely to happen again.
On drug use, Policy Manual Volume defines drug abuse and drug addiction as a current substance use or substance-induced disorder involving a controlled substance. An applicant later certified by a civil surgeon or panel physician to be in remission, under the applicable HHS regulations and CDC Technical Instructions, is no longer inadmissible on that ground.
Cannabis is a special case because federal law controls it, no matter what state law says where you live or use it. While waivers exist for some health-related grounds of inadmissibility, eligibility depends on your specific finding and visa category. If you face a Class A finding, consult legal counsel immediately.
Most Form I-693 issues come down to simple paperwork errors, which are easy to avoid while you're still at the doctor's office. Review your copy with this checklist before the civil surgeon seals your envelope.
If you are applying through an employment-based green card route like the EB-1 or EB-2 NIW, keep these four key points in mind:
1. Complete the exam before you submit your application
When you file Form I-140 and Form I-485 together, include your sealed medical exam in the original package. You cannot send it in later. Check out our guide on filing for adjustment of status after I-140 approval for step-by-step timing details.
2. Retrogression long waits won't invalidate your exam
Employment-based applications can remain pending for years due to priority date backlogs. Fortunately, under current rules, your Form I-693 stays valid for as long as your application is pending, saving applicants from backlogged countries from having to repeat the exam.
3. A denial or withdrawal resets the process
If USCIS withdraws or denies your Form I-485, your Form I-693 is no longer valid. Refiling later means undergoing a fresh examination, repeating lab tests, and paying all fees again for yourself and any dependents.
4. Every family member needs an individual exam
Your spouse and each dependent child must schedule their own exam, complete their own lab work, and pay the full fee. While the exam is relatively inexpensive compared to the overall green card process, missing or incorrect medical documentation can cause severe delays or rejections.
Form I-693 is a small part of an adjustment package and one of the easier parts to mess up. Beyond Border attorneys review the complete filing before it goes out, including whether your medical report meets the validity rule in force, uses the accepted edition, and is complete on every line USCIS checks.
We will also tell you if an EB-2 NIW self-petition is not the right route for your profile, and which category fits your record better. That assessment is the point of the consultation, and it is as useful when the answer is no. Request an honest assessment of your EB-2 NIW case.
As of September 2026, a form signed by a civil surgeon on or after November 1, 2023, is valid only while the application it was filed with is pending. If USCIS denies or withdraws that application, the form is no longer valid.
You must file it with your Form I-485. USCIS may reject Form I-485 if you don't include the required Form I-693.
USCIS does not charge a fee for the form and does not regulate what civil surgeons charge. However, you can expect to pay around US$250 to US$500 for the examination and laboratory work, with missing vaccines adding US$50 to several hundred dollars on top.
Insurance plans often don't cover these exams because they're considered administrative, not medically necessary. However, you might be able to get some vaccines or lab tests covered. Check with your insurance provider directly, and if you have questions about using a health savings account, talk to a tax advisor.
The exam checks for 15 vaccine-preventable diseases based on your age, per CDC guidelines. COVID-19 vaccines are no longer required. Be sure to bring all your vaccination records; proof of past shots can save you from repeating doses and paying extra.
Only if your physician is a USCIS-designated civil surgeon. USCIS will not accept a report from any other doctor, no matter how thorough.
USCIS will return the form, and you will need to repeat the exam and pay again. The same applies if the envelope arrives unsealed or shows signs of alteration. Ask for a separate complete copy for your own records instead.
There is no "pass" or "fail" for the medical exam. The doctor simply logs any health findings. You'd only be considered inadmissible if you have a Class A condition, such as a communicable disease, missing required vaccines, a physical or mental disorder tied to harmful behavior, or drug abuse/addiction. If a Class A finding does come up, speak with an immigration attorney right away, as waivers are available for certain conditions depending on your situation.
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