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I-693 — Medical Examination.

Form I-693 is the medical examination report completed by a USCIS-designated Civil Surgeon. Required for I-485 applicants to demonstrate they're not medically inadmissible.

📋 USCIS Form💲 Civil surgeon fee⏱ Valid 2 years💉 Vaccinations

Form I-693 is the medical examination report completed by a USCIS-designated Civil Surgeon. Required for I-485 applicants to demonstrate they're not medically inadmissible.

Quick Reference

Filing fee: Varies (~$200-$500) · Processing time: Valid 2 years · USCIS link: uscis.gov/i-693

Who must complete I-693

I-485 adjustment of status applicants must submit I-693, with limited exceptions:

  • Refugees who completed exam abroad less than 1 year before arrival
  • Some K visa holders if exam was current at consular interview
  • NACARA, HRIFA, and other special category adjustments

Finding a Civil Surgeon

Only USCIS-designated Civil Surgeons can perform the I-693 examination. Find one via the USCIS Civil Surgeon Locator at uscis.gov.

Costs vary by region and provider — typically $200-$500. Vaccinations are usually extra. Insurance does NOT cover the immigration medical exam.

Key practitioners to ask about pricing:

  • Base medical exam fee
  • Tuberculosis testing (chest X-ray if positive screening)
  • Required vaccinations (varies by age and previous vaccinations)
  • Lab work (syphilis, gonorrhea screening)

Components of the examination

  1. Medical history review
  2. Physical examination
  3. Mental status evaluation
  4. Tuberculosis screening — TB skin test, IGRA blood test, or chest X-ray
  5. Syphilis screening — required for ages 18+
  6. Gonorrhea screening — required for ages 18-24
  7. Vaccination assessment — review immunization records
  8. Drug screening if indicated by history

Required vaccinations

  • Mumps, Measles, Rubella (MMR)
  • Polio
  • Tetanus and Diphtheria toxoids
  • Pertussis
  • Haemophilus influenzae type B
  • Hepatitis A and B
  • Rotavirus
  • Meningococcal disease
  • Varicella (chickenpox)
  • Pneumococcal pneumonia
  • Seasonal influenza
  • COVID-19 (currently — subject to policy changes)

Validity period

I-693 is valid for 2 years from the date the Civil Surgeon signs it. USCIS uses the I-693 to determine medical admissibility — the form must be valid when the I-485 is adjudicated, not just when filed.

Strategy: Time your I-693 to maximize the chance it's still valid at adjudication. Don't get the exam too early in the I-485 process. Generally complete the exam after biometrics or once you receive an interview notice.

Submitting the I-693

The Civil Surgeon completes I-693, signs and seals it in an envelope. Do NOT open the envelope — submit it sealed with your I-485 (or in response to a USCIS request).

If filing I-485 by mail, include the sealed envelope with the application. If submitting in response to an RFE or at an interview, bring the sealed envelope.

Inadmissibility findings

The Civil Surgeon classifies findings:

  • Class A — communicable disease of public health significance, lack of required vaccinations, mental disorder with harmful behavior, drug abuse
  • Class B — health conditions that don't constitute inadmissibility but may require follow-up

Class A findings can be addressed via:

  • Treatment (e.g., active TB treatment to render non-infectious)
  • Vaccination completion
  • Form I-601 waiver of inadmissibility (specific grounds)