When should I submit Form I-693 with my adjustment of status application?

Virtually everyone who adjusts 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 show that they are free from health conditions that would make them inadmissible.

RECOMMENDED: What Happens at an Immigration Medical Exam

Form I-693, Explained

When immigrating to the United States, most applicants are required to undergo a medical examination. This requirement helps the U.S. government protect public health. The medical examination, along with the resulting report and vaccination record, allows USCIS to assess whether an individual meets the health-related criteria for admissibility. Form I-693 serves as the official document for reporting these medical exam results. The exam must be conducted by a USCIS-approved doctor, known as a civil surgeon, who records the findings on Form I-693. USCIS uses this form to determine whether an applicant is inadmissible on public health grounds.

Four basic medical conditions may make an applicant inadmissible on health-related grounds:

• Communicable disease of public health significance
• An immigrant’s failure to show proof of required vaccinations
• Physical or mental disorder with associated harmful behavior
• Drug abuse or addiction

RECOMMENDED: Grounds of Inadmissibility

Who Must Submit Form I-693

Almost every applicant for permanent residence must show that they are not inadmissible on the public health grounds. This does not apply to registry applicants and individuals born under diplomatic immunity in the United States. If you are filing Form I-485 under the nonimmigrant K-1/K-2 fiancé(e) or K-3/K-4 spouse categories and already had a medical examination overseas, you are not required to have another medical examination as long as you file your Form I-485 within one year of an overseas medical examination; and

• The panel physician did not find a class A medical condition during your overseas examination; or
• The panel physician did find a class A medical condition, you received a waiver of inadmissibility, and you have complied with the terms and conditions of the waiver.

Even if a new medical examination is not required, you must still show proof that you complied with the vaccination requirements. If the vaccination record (DS 3025) was not properly completed and included as part of the original overseas medical examination report, you will need to have the Vaccination Record completed by a designated civil surgeon.

RECOMMENDED: I-485 Checklist for Family-Based Applications

When to Submit Form I-693

As of December 2024, USCIS requires that you submit Form I-693 with your Form I-485. You may not opt to mail the medical exam results at a later date. If you do not submit Form I-693 as a part of your adjustment of status application package, USCIS may reject your entire application.

Although USCIS previously allowed applicants to submit Form I-693 after the application, that is no longer an option. It’s always been best practice to submit the medical exam results at the same time as Form I-485 for the most efficient processing times.

What’s more, USCIS changed it’s policy in 2024 on the validity period of Form I-693. Any Form I-693, Report of Immigration Medical Examination and Vaccination Record, that was properly completed and signed by a civil surgeon on or after November 1, 2023, does not expire and can be used indefinitely as evidence to show that the applicant is not inadmissible on health-related grounds.