Do I need to 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

Purpose of the Medical Examination

The medical grounds of inadmissibility, the medical examination of foreign nationals, and the vaccinations administered to foreign nationals are designed to protect the health of the United States population. The immigration medical examination, the resulting medical examination report, and the vaccination record provide the information USCIS uses to determine if a foreign national meets the health-related standards for admissibility.

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

USCIS uses Form I-693 to gather results of a medical examination. The U.S. government requires the examination to establish that an applicant is not inadmissible to the United States on public health grounds.

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 Part 10. Vaccination Record completed by a designated civil surgeon. In this case, you must submit Parts 1-5, 7, and 10 of Form I-693.

When to Submit Form I-693

Generally, it’s best to submit Form I-693 as part of the adjustment of status package. When you submit a complete application package, you make it easier for USCIS officers to give you a speedy approval. CitizenPath recommends that its customers submit the I-693 along with Form I-485, Application to Register Permanent Residence or Adjust Status. USCIS generally considers a completed Form I-693 to retain its evidentiary value for two years after the date the civil surgeon signed Form I-693.

However, USCIS does not currently require you to submit Form I-693 at the time you file Form I-485. Some people choose to submit the medical exam at the time of the in-person interview. While some applicants intend to bring their completed Form I-693 to their interview, some applications may not require an interview. USCIS makes decisions to waive interviews on a case-by-case basis. This would force USCIS to issue an RFE to request your medical exam results and would delay the progress of your case.

The results of an immigration medical exam generally do not expire. Specifically, 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.

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Only a USCIS designated civil surgeon can perform this medical examination in the United States. The civil surgeon must document the results of your medical examination on Form I-693. For more information on the medical examination, see the Form I-693 instructions.