Form I-693: Instructions, Costs, Validity, and Medical Exam in 2022 (2023)

Those seeking to come to the United States (or are trying to change their status inside the U.S.) must prove that they do not pose a health risk to the general public. Ensuring an applicant can meet the government standards for public health is done through a medical exam. On this page, you will learn all about I-693, instructions, validity, costs, and its role in your medical exam.

What is a Form I-693 Medical Exam?

The official name for the immigration Form I-693 is the ‘Report of Medical Examination and Vaccination Record.’ This form must be completed by the applicant and an appointed doctor before it can be submitted.

The Form I-693 medical exam is not a comprehensive exam for all health-related reasons. It is an exam to check for certain types of medical issues that are of interest to immigration agencies and legislation. The doctor is not required to check, diagnose, or provide treatment for problems outside of this interest. The medical exam does not involve surgery.

Throughout the exam, the doctor will go through the applicant’s medical history. They will also perform a basic physical examination.The doctor will be searching for evidence of the following in particular:

• Diseases that easily spread from person to person (T.B., syphilis, and gonorrhea);
• A history of drug abuse or addiction to drugs;
• Physical or mental disorders that may lead to harmful behavior towards others; and
• Conditions that prevent an applicant from being able to sustain themselves.

To test for transmissible diseases, the doctor will conduct a tuberculosis test, a blood test and a urine test. They will also perform drug and alcohol screenings, including checking an applicant’s prescription use.

The doctor will check that an applicant has had all the required vaccinations. This can update frequently so the current list should be checked before starting an immigration application. The required I-693 vaccines currently include:

• Mumps;
• Measles;
• Rubella;
• Polio;
• Tetanus and Diphtheria Toxoids;
• Pertussis;
• Haemophilus influenzae type B;
• Hepatitis B;
• COVID-19; and
• Any other vaccine-preventable diseases are recommended by the Advisory Committee for Immunization Practices.

After completing the medical exam, the doctor will prepare a report summarizing their medical findings for the immigration authorities. They will keep Form I-693 so they can complete their relevant sections.

Eligibility: When is I-693 Required?

Any applicant living outside the U.S. must complete the Form I-693 medical exam in addition to the Form I-485. If the medical exam is not completed, or the Form I-693 is not submitted within the proper time frame, then their application will not be approved.

If an applicant fails to submit a completed Form I-693, immigration officers can issue a Request for Further Information or their Notice of Intent to Deny, or deny the applicant entry into the U.S. If all procedures are complied with but the officer has reason to believe the applicant’s medical has changed since the submission, they may request the applicant complete a second medical exam.

Certain applicants who were already examined abroad by a panel physician usually do not need to repeat the Form I-693 medical exam when applying for an adjustment of status after they have settled into the U.S. These include non-immigrant fiancé(e)s or spouses of U.S. citizens, spouses of lawful permanent residents, refugees and asylee dependents. Any applicant considering this should look up the current rules to ensure this applies to them.

I-693 Cost

There is no separate filing form fee for Form I-693 as part of a Green Card application. However, the civil surgeon or panel physician performing the medical exam will charge for their services. The matter of costs is not regulated by the USCIS or the U.S. Department of Health. The price range for a Form I-693 medical exam depends on the state and provider, but applicants can expect to pay between $100 and $500. The average cost for the exam is around $200.

Processing Times

It generally takes 2 weeks to schedule a Form I-693 medical exam, and 2 weeks after that to receive the complete and sealed Form I-693. A properly signed and submitted Form I-693 will remain valid for 2 years. The current processing time for a full Green Card application is 6 months to 4 years. If 2 years pass and an applicant has not been approved for a Green Card, USCIS will likely send a Request for Evidence asking that the applicant completes a second medical exam.

Form I-693 Instructions

The USCIS webpage for Form I-693 has both a file of the Form I-693 to be printed off and filled in and a file for the Form I-693 Instructions. This document is split into Instructions for Applicants and Instructions for the Civil Surgeon/Panel Physician.

Form I-693 is split into 11 parts. The applicant only needs to fill in Part 1 before attending their medical exam. The remaining parts will be filled in by the doctor performing the exam and any other health officials involved.

It is important to note that while an applicant should fill in Part 1 of Form I-693 prior to the medical exam, they must only provide their signature on the Form in the presence of the doctor performing the exam. For applicants under 14 years old or a mentally incompetent applicant, a legal guardian can sign.

To fill in Part 1, the applicant must provide their:

• Full name;
• Physical address;
• Gender;
• Date of Birth;
• City/Town/Village of Birth;
• Country of Birth;
• Alien Registration Number (for applicants inside the U.S.); and
• USCIS Online Account Number.

How to File

After the medical exam is complete, the civil surgeon/panel physician will provide the applicant with their completed Form I-693 in a sealed envelope and a copy for the applicant’s own records. The enveloped form must not be opened or placed in a new envelope. USCIS will not accept Form I-693 if this envelope is opened or altered in any way. The applicant must submit this sealed Form I-693 to USCIS. The doctor will not provide a copy to USCIS.

For applicants residing inside the U.S., Form I-693 can be submitted by mail alongside the initial Form I-485. Both Forms must be submitted to the address specified for the I-485. If an applicant has already submitted Form I-485 but has had further communications with USCIS (such as a Request For Evidence letter), any further mail from USCIS will specify a location for further communications. This includes the address Form I-693 should be mailed to. If an applicant needs to attend an interview at a USCIS field office, they can submit the envelope in person at the interview.

For applicants residing outside the U.S., the medical office that requested the examination will provide instructions for how to submit the envelope. Since these applicants cannot schedule a medical exam before their interview date is set, USCIS will clarify when to submit Form I-693. Usually, the best time to submit for these applicants is at their interview. Applicants who are unsure of how/where to submit can contact the USCIS Contact Center.

I-693 Medical Exam Checklist

An applicant will need many materials to prepare for the medical exam and fill in Form I-693. For an applicant living outside the U.S., the US Embassy will provide an applicant with special instructions depending on the country. All applicants will need to bring the following items to their medical exam:

• The following items for all applicants:
  • A valid passport or other government-issued picture identification;
  • Their vaccination records;
  • The doctor’s fee;
  • Number of U.S passport photographs required (may vary depending on country); and
  • The Form I-693 with Part 1 already filled in.
• For applicants adjusting their status instead of applying from abroad, their Form I-693 Report of Medical Examination and Vaccination Record;
• For applicants who have learning disabilities or family members that do, a description of the ailment and any specific schooling or monitoring needs;
• For applicants being treated for a chronic medical condition or taking regular medication, their medication chart;
• For applicants with a past positive skin test for T.B., a tuberculosis certificate to prove that they have been properly treated;
• For applicants who have had syphilis, a certificate of clearance stating that they were properly treated, signed by a doctor/public health official;
• For applicants who have had an abnormal X-ray chest result (this may be a sign of T.B), the X-ray films (a written report may not suffice, check with your appointed civil surgeon/panel physician);
• For applicants who have been treated or hospitalized for psychiatric/mental illness or alcohol/drug abuse, written certification from a doctor of their diagnosis, duration of treatment and prognosis; and
• For applicants with a record of destructive/aggressive conduct that has caused injury to people/animals, their current doctor if this behavior was the result of a mental/medical condition or by drug/alcohol abuse. This includes injury to oneself, such as self-harming or suicide attempts.

Form I-693 Public Health Grounds for Inadmissibility

There are 4 categories of medical reasons for why an applicant can be refused entry into the U.S.:

• Diseases that are spread from person to person (T.B., syphilis, and gonorrhea);
• A history of drug abuse or addiction to drugs;
• Physical or mental disorders that may lead to harmful behavior towards others; and
• Conditions that prevent an applicant from being able to sustain themselves.

Aside from the category of infectious diseases, these categories may not result in an immediate denial of entry. An applicant may still be allowed entry if they provide evidence that they have been treated or are receiving treatment for their condition, and they will not pose a danger to themselves or others because of them. As of 2018, the infectious diseases that might lead to an application being rejected are:

• Gonorrhea;
• Infectious Leprosy;
• Infection-Stage Syphilis; and
• Tuberculosis (T.B).

Any other infectious diseases that an applicant has not received vaccinations may deny them entry into the U.S. The potential for infection or harm to others is why applicants must provide evidence of vaccinations and any ongoing treatment to their medical exam. A I-693 Form with missing vaccination records may be able to waive these depending on circumstances, e.g., one vaccination is not available in the applicant’s country.

What Doctor Do I Need to See?

I-693 doctors have two different types. The right type for an applicant to see depends on whether the applicant is applying from within or outside the U.S. A medical exam performed by anyone not accredited with the following titles will not be accepted.

Applicants within the U.S. will need to see a civil surgeon appointed and accredited by the U.S. Citizenship and Immigration Services (USCIS). A civil surgeon is a licensed doctor who has worked in their chosen specialization for at least 4 years. They are accountable for maintaining their standards and meeting all rules set out by the Centers for Disease Control and Prevention in the U.S.

Applicants will need to find a civil surgeon to make an appointment for a medical exam. The USCIS website has a Find the Doctor webpage for this function. Applicants outside the U.S will need to see a panel physician authorized by the U.S Department of State. Panel physicians will perform a medical exam in the U.S Embassy or a consulate in the applicant’s country. A list of available panel physicians will be sent to the applicant once their interview has been scheduled.

FAQs About Form I-693

Below you will find answers to the most commonly asked questions about I-693.

How Much Does the I-693 Cost?

Form I-693 filing does not carry an individual charge. However, this does include the cost of filing Form I-485 as part of the overall Green Card application. The doctor performing the medical exam will also probably charge for their services. There is no regulation regarding the costs of the USCIS I-693 medical exam. An applicant can expect to pay between $100 to $500 for the Form I-693 medical exam and $1225 for Form I-693 interfiling. The latter is the cost of filing the Form I-485, which can potentially be reduced or waived depending on the applicant’s circumstances. Please see that section for details.

Can I Submit I-693 After the Interview?

The best time for an applicant to submit the sealed Form I-693 is alongside the Form I-485, or failing that, at the I-485 interview. It is not recommended to send a standalone Form I-693 without being asked by USCIS. Due to their heavy caseload, USCIS may not associate the applicant’s Form I-693 with their Form I-485, especially if that Form has been shuffled between field offices. A single Form I-693 can easily get lost and misplaced, requiring an applicant to schedule and pay for another medical exam. If an applicant has to submit their I-693 after the interview, it would be best to wait for a Request For Evidence notice to be sent asking for the Form. This will provide the address where the applicant’s Form I-485 is kept, making the risk of the Form being misplaced very small. It should hopefully also allow for that case to be reviewed faster since they are expecting the Form so they can complete the file.

How Long Does It Take to Get an I-693?

For applicants inside the U.S., it generally takes 2 weeks to schedule a Form I-693 medical exam, and 2 weeks after that to receive the complete and sealed Form I-693. It is ideal for this to be filed alongside Form I-485. This will avoid scheduling rushes or problems, but in these cases both forms must be submitted within 60 days of receiving the sealed envelope. If an applicant must schedule their exam after submitting Form I-485, it is ideal to have a completed and signed Form I-693 before their interview. They can submit the Form at the interview without the risk of the Form being misplaced.

For applicants outside the U.S., the National Visa Center will inform them when it is time to schedule their I-693 medical exam. This must take place before their I-485 interview. They will also provide a list of panel physicians the applicant can contact. Depending on the doctor and the applicant’s location it may take 2 weeks to receive the appointment, and another 2 weeks for all the exam results to be finished. The USCIS is aware of this and will account for it when they schedule the interview. It is best for the applicant to make the appointment as soon as they can once they receive the interview date.

What is I-693 Validity?

I-693 validity means that it was verified by a doctor and submitted close to when the applicant’s Form I-1485 was filed. A valid Form I-693 will be accepted by USCIS for a long duration once it is correctly submitted. If an I-693 Form outlasts its validity period, it expires, and the applicant will have to get a second complete Form before their Form I-485 application can be approved. How long the I-693 Medical Form remains valid depends on when the Form was signed by the civil surgeon/panel physician:

• If it was signed no more than 60 days before the applicant submitted their Form I-485, it remains valid for 2 years from the date of signing
• If it was signed after the applicant submitted their Form I-485, it remains valid for 2 years from the date of signing
• If it was signed more than 60 days before the applicant submitted their Form I-485, it is not considered valid