Form I-693: Immigration Medical Exam and Vaccination Guide 2026

# Form I-693: The Complete Guide to Your Immigration Medical Exam in 2026

If you are applying for a green card in the United States, one requirement you cannot skip is the Form I-693, Report of Medical Examination and Vaccination Record. This form proves that you have undergone a medical examination by a [USCIS-designated civil surgeon](https://www.uscis.gov/tools/find-a-civil-surgeon) and that you meet the health-related requirements for lawful permanent residence.

At Reinvent NY, we help our clients navigate every step of the immigration process, including the medical exam. In this guide, we break down exactly what the I-693 form is, who needs it, how to prepare, what it costs, and how to avoid common mistakes that delay green card approvals.

---

What Is Form I-693 and Who Needs It?

Form I-693 is an official USCIS document that records the results of your immigration medical examination and vaccination history. It is not a form you fill out yourself. Instead, a USCIS-designated civil surgeon completes it after examining you and reviewing your vaccination records.

You need this form if you are filing any of the following:

- Form I-485, Application to Register Permanent Residence or Adjust Status
- Form I-762, in certain cases related to Temporary Protected Status
- Any other application where USCIS requires proof of medical admissibility

In practical terms, nearly every person applying for a green card from inside the United States through adjustment of status must submit a completed I-693. If you are going through consular processing abroad, the medical exam is handled by a panel physician at the U.S. embassy or consulate, and Form I-693 does not apply.

There are limited exceptions. Certain applicants who received a medical exam abroad within the validity period, or refugees who completed an overseas exam, may not need a new I-693. However, if USCIS determines that your previous exam is incomplete or expired, they will request a new one.

According to [USCIS policy guidance](https://www.uscis.gov/policy-manual/volume-8-part-b), the medical examination ensures that applicants do not have a Class A medical condition that would make them inadmissible, such as certain communicable diseases or a lack of required vaccinations.

---

How to Find a Civil Surgeon and Prepare for the Exam

Not just any doctor can complete your I-693. You must visit a civil surgeon who has been designated by USCIS. These are licensed physicians (M.D. or D.O.) who have applied for and received authorization from USCIS to perform immigration medical examinations.

To find one near you, use the official [USCIS Civil Surgeon Locator](https://www.uscis.gov/tools/find-a-civil-surgeon). You can search by ZIP code, city, or state. In the New York City metropolitan area, there are hundreds of designated civil surgeons, but we recommend calling ahead to confirm availability, pricing, and what documents to bring.

What to bring to your appointment:

- A government-issued photo ID (passport, state ID, or driver's license)
- Your vaccination records (as complete as possible)
- A copy of your I-485 receipt notice, if available
- Any prior medical records related to conditions listed on the I-693
- Payment (most civil surgeons require payment at the time of the visit)

Having complete vaccination records is critical. If you are missing records, the civil surgeon will need to administer the required vaccines at your appointment or refer you to a facility that can, which adds time and cost.

---

Required Vaccinations and the Medical Exam Process

USCIS requires applicants to show proof of vaccination against a specific list of diseases. The civil surgeon will review your records and determine which vaccines you still need. The requirements follow the recommendations of the Advisory Committee on Immunization Practices (ACIP), as referenced in the [USCIS vaccination requirements](https://www.uscis.gov/tools/designated-civil-surgeons/vaccination-requirements).

Required Vaccinations Checklist

The COVID-19 vaccine was removed from the required list effective October 2023 per [CDC guidance](https://www.uscis.gov/newsroom). This is a change from previous years that our clients frequently ask about.

What Happens During the Exam

The medical exam itself typically takes 30 to 60 minutes and includes:

1. Medical history review -- the civil surgeon asks about your past and current health conditions
2. Physical examination -- a standard physical including eyes, ears, heart, lungs, abdomen, and skin
3. Mental health screening -- a brief assessment for any mental health conditions
4. Vaccination review -- the doctor checks your records against the required list and administers any missing vaccines
5. Lab tests -- blood draw for syphilis (RPR/VDRL), gonorrhea, and tuberculosis screening (IGRA blood test or chest X-ray if indicated)

After the exam, the civil surgeon completes Form I-693, signs it, and seals it in an envelope. In most cases, you will receive the sealed form to submit with your I-485. Some civil surgeons send results directly to USCIS, but this is less common.

---

Validity, Timing, and Cost of the I-693

Understanding the validity rules for Form I-693 is essential. Filing with an expired or improperly timed form is one of the most common reasons for a Request for Evidence (RFE) from USCIS.

Validity Rules

- The I-693 is valid for 2 years from the date the civil surgeon signs it
- USCIS must make a decision on your case within that 2-year window
- You should submit the I-693 no more than 60 days before filing your I-485, or at any time after filing while your case is pending

The 60-day rule is important. If your civil surgeon signs the form on January 1, 2026, you can submit it with an I-485 filed as early as November 2, 2025 (60 days before) through January 1, 2028 (2 years after signing). Filing outside these windows will result in USCIS rejecting the form.

For full details, see the [USCIS I-693 instructions page](https://www.uscis.gov/i-693).

Cost Breakdown

In the New York City area, we typically see our clients paying between $300 and $500 for the complete exam including vaccinations. Prices vary significantly between providers, so we recommend calling at least 2 or 3 civil surgeons to compare.

Insurance generally does not cover the immigration medical exam itself, though some plans may cover individual vaccinations. Always ask your provider and your insurance company before your appointment.

---

Common Issues, Rejections, and How to Avoid Them

Over the years, we have seen the same I-693 problems come up repeatedly. Here are the most common issues and how to avoid them.

Expired form. The number one problem. If USCIS does not adjudicate your case within 2 years of the civil surgeon's signature, you will need a new exam. There is nothing you can do to prevent this if processing times are long, but filing a complete and accurate application reduces the chance of delays.

Missing vaccinations. If the civil surgeon marks that you are missing required vaccines and you do not get them, USCIS will issue an RFE. Make sure every required vaccine is either administered or documented with a valid medical waiver.

Incorrect or incomplete form. Civil surgeons sometimes make errors -- wrong dates, missing signatures, incomplete sections. Review the form (you can open the sealed envelope; USCIS allows this) and confirm all fields are filled in correctly before submitting.

Using a non-designated physician. Only USCIS-designated civil surgeons can complete the I-693. An exam performed by your regular doctor, an urgent care clinic, or a physician abroad (unless a designated panel physician) will not be accepted.

Not submitting the form at all. Some applicants forget to include the I-693 with their I-485 filing. While you can submit it later, doing so invites an RFE and delays your case by weeks or months.

Medical waiver issues. If you cannot receive a vaccine for medical reasons, the civil surgeon must document a medical waiver on the form. Without proper documentation, USCIS may reject the waiver and require the vaccination anyway.

Our recommendation: schedule your medical exam 2 to 4 weeks before you plan to file your I-485. This gives you enough time to complete any multi-dose vaccine series and address any issues with the form before submission.

---

Final Thoughts

The I-693 form is a mandatory part of the green card process that catches many applicants off guard. The exam itself is straightforward, but the timing, vaccination requirements, and paperwork details create real opportunities for mistakes that delay your case.

The key takeaways: find a USCIS-designated civil surgeon early, bring complete vaccination records, understand the 2-year validity window, and review the completed form before submitting it. Budget $200 to $500 for the process, and schedule the exam well before your I-485 filing date.

At Reinvent NY, we guide our clients through every detail of the adjustment of status process, including coordinating the I-693 medical exam. If you have questions about your green card application or need help preparing your filing, [reach out to us through our consultation form](https://docs.google.com/forms/d/11dV2EAJwqcnYLRKvRI70A9BJOWBwZpAzeODotMbereg/viewform).

---

FAQ

What is the I-693 form used for?

Form I-693 is the Report of Medical Examination and Vaccination Record. It documents the results of your immigration medical exam and vaccination history, and it is required for most green card applicants filing Form I-485 (adjustment of status) inside the United States.

How long is the I-693 valid?

The form is valid for 2 years from the date the civil surgeon signs it. USCIS must make a decision on your application within that 2-year window, or you will need a new exam.

Can I open the sealed I-693 envelope?

Yes. USCIS has confirmed that applicants may open the sealed envelope to review the form for accuracy. The civil surgeon's seal is for identification purposes, not a condition of acceptance. You can submit the form even if the envelope has been opened.

How much does the I-693 medical exam cost?

The total cost typically ranges from $200 to $500, depending on your location, the civil surgeon's fees, and how many vaccinations you need. In the NYC area, expect to pay toward the higher end of that range.

Is the COVID-19 vaccine still required for the I-693?

No. As of October 2023, the COVID-19 vaccine was removed from the list of required vaccinations for immigration purposes. You do not need a COVID-19 vaccine to complete Form I-693.

What happens if my I-693 is rejected?

If USCIS finds an issue with your I-693, they will typically issue a Request for Evidence (RFE) asking you to submit a corrected or updated form. Common reasons include expired forms, missing vaccinations, or incomplete fields. You will usually have 87 days to respond to an RFE.

Can my regular doctor complete the I-693?

No. Only a USCIS-designated civil surgeon can complete Form I-693. You can find one using the [USCIS Civil Surgeon Locator](https://www.uscis.gov/tools/find-a-civil-surgeon). Your regular doctor's exam will not be accepted.

When should I schedule my I-693 medical exam?

We recommend scheduling the exam 2 to 4 weeks before you plan to file your I-485. This gives you time to complete any required vaccinations and address potential issues with the form before submission.

---