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All about Form I-693 and the immigration medical examination

USCIS requires adjustment of status applicants to have a medical examination to ensure that they don’t have a health condition that could make them “inadmissible” to the United States.

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Almost everyone who adjusts their status to permanent resident (Green Card holder) must submit Form I-693, Report of Medical Examination and Vaccination Record, as a part of the process. U.S. Citizenship and Immigration Services (USCIS) requires adjustment of status applicants to have a medical examination to ensure that they don’t have a health condition that could make them “inadmissible” to the United States. 

What is Form I-693?

Form I-693, Report of Medical Examination and Vaccination Record is one of the requirements set by the U.S. Citizenship and Immigration Services (USCIS) for foreign nationals that show they're in good health and don't have illnesses that could cause harm to others. 

You must visit a doctor that has been authorized by USCIS (if you’re applying in the U.S.) or the United States Department of Health, who will conduct the exam and share their findings on Form I-693. You will typically receive one copy in a sealed envelope that will be sent to USCIS as well as a copy for your records. 

Medical conditions that may be grounds for inadmissibility 

The purpose of the medical exam is to ensure to applicants don’t pose a health threat to current U.S. residents. The main health-related reasons why a person might be denied a Green Card include the following:

Communicable diseases. The U.S. Department of Health and Human Services (HHS) currently identifies the following diseases as barriers to admission: 

  • Tuberculosis (TB)

  • Gonorrhea

  • Syphilis in its infectious stage

  • Infectious leprosy

Drug abuse or addiction. Applicants who deemed drug abusers or addicts are inadmissible.  If you have a history of drug abuse, you might be asked to take a drug test and/or certify that you have completed a drug treatment program. 

Failure to show proof of certain vaccines. The doctor is required to make sure that you’ve received all required vaccines. While you’re advised to obtain these vaccinations before your Green Card interview, the doctor may be able to provide these vaccines during your medical exam. Check regularly for updates as the list is subject to change.

  • Measles, mumps, rubella (MMR)

  • Polio

  • Pertussis

  • Tetanus and diphtheria toxoids

  • Hepatitis B

  • Haemophilus influenza type B (HIB)

  • Varicella (chickenpox)

  • Influenza

  • Rotavirus

  • Pneumococcal pneumonia

  • Meningococcal

  • Hepatitis A

Mental or physical disorders that lead to harmful behavior. Applicants who have current or past physical or mental disorders associated with harmful behavior may be deemed “inadmissible.”

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Who has to submit Form I-693? 

Foreign nationals applying for legal permanent residence in the U.S. are typically required to submit Form I-693. However, they may be exceptions for applicants who have previously completed a medical exam prior to entering the U.S., such as if you are entering the country on a K-1 fiancé visa. The results from this previous medical exam may be used by USCIS to determine your admissibility for a Green Card.

USCIS typically suggests that applicants file Form I-693 along with Form I-485, Application to Register Permanent Residence or Adjust Status.

How long are examination results valid?

For applicants who are already in the U.S. and applying for a change of status, the medical examination usually should be no more than two months old when it's submitted to USCIS. Otherwise, the results are valid for two years. 

Where to obtain form I-693

Form I-639 is free of charge and can be downloaded from the USCIS website. Alternatively, you may request for physical forms to be mailed to your address by calling 1-800-375-5283.

How to find qualified doctors for a I-693 medical exam

Only two types of doctors can perform a medical exam for Form I-693:

  • If you’re applying from within the United States, a civil surgeon : designated by U.S. Citizenship and Immigration Services (USCIS) will conduct your medical exam. 

  • If you’re applying from abroad, a panel physician : authorized by the U.S. State Department will conduct your medical exam. 

To locate a designated civil surgeon near you, you may visit the USCIS website, select “tools” and click on “find a doctor". You may then input your  address to view a list of civil surgeons in your area. You can also call 1-800-375-5283 to speak to a representative who may be able to provide you with a list of qualified doctors near you.

What to expect at a medical examination 

When you attend your medical appoint, bring the following materials: 

  • Immunization or vaccination records

  • Copy of your medical history

  • Letter from your doctor outlining the treatment plan for any ongoing or past medical conditions 

  • Government-issued photo ID

  • Payment for the medical exam fee (check with the doctor’s office before your appointment for acceptable payment options)

  • Your health insurance card, if applicable (check with the doctor’s office before your appointment if they accept your insurance)

During the exam, you may expect the following:

  • Tuberculosis tests, which are based on guidelines from the Centers for Disease Control and Prevention (CDC)

  • Blood and urine tests for syphilis and gonorrhea for all applicants 15 years and older 

  • Vaccination screening 

  • Drug and alcohol screening 

What to expect after the medical examination

The doctor will provide your medical results, X-ray and signed Form I-693 in a sealed envelope. The physician may then place the form in a sealed envelope and return it to you.  Do not break the seal or open the envelope as this may invalidate the form. 

Doctors will also normally provide a copy of the results for your records. If they don’t automatically give you a copy, you can ask for one before they seal the envelope.

Is there a filing fee for Form I-693?

There is no cost to filing Form I-693; however, you may be required to pay the filing fee for Form I-485 when you apply for Green Card status. More information on the fees associated with Form I-485 may be found on the USCIS website.

The takeaway

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