Form I-693, officially the Report of Medical Examination and Vaccination Record, is the official USCIS document that documents a foreign national's immigration medical examination and vaccination compliance, signed by a designated civil surgeon. When you apply for a green card through adjustment of status (Form I-485), USCIS now requires you to submit a completed Form I-693 with your initial application, or the agency may reject your entire application before review. This form determines whether your health status creates an immigration barrier. The exam checks for communicable diseases, required vaccinations, and certain medical or behavioral conditions that could make you inadmissible—but most health findings do not automatically block a green card.
Table of Contents
- Who Can Complete Your Medical Exam
- What the Civil Surgeon Examines
- Class A Findings Make You Automatically Inadmissible
- Class B Findings and Your Green Card Eligibility
- The One-Application Limit on Form Validity
- Frequently Asked Questions
Who Can Complete Your Medical Exam
Only a USCIS-designated civil surgeon can complete and sign Form I-693; your regular doctor cannot, even if licensed and experienced. A civil surgeon must have at least four years of medical experience, current USCIS training on Technical Instructions, and active agency designation. You can find designated civil surgeons on the USCIS website, searchable by zip code. Call ahead to confirm they accept your insurance or payment method and ask about their wait time for appointments—demand can vary widely by location.
What the Civil Surgeon Examines
The civil surgeon evaluates your health status against two classifications: Class A and Class B conditions. The examination verifies whether you have received all age-appropriate vaccinations per CDC guidelines and checks for any Class A or Class B medical conditions, documenting everything on Form I-693.
bring your vaccination records, medical history, and any documentation of chronic conditions you have. The exam typically includes vital signs, a physical examination, and a medical history review. If you have a known medical condition or prior diagnosis, bring records from your doctor—the civil surgeon will document findings thoroughly.
Class A Findings Make You Automatically Inadmissible
Class A conditions automatically render an applicant inadmissible on health grounds and include communicable diseases of public health significance, missing proof of required vaccinations, physical or mental disorders with harmful behavior, and substance use disorders unless a medical waiver is granted. If the civil surgeon documents a Class A condition, USCIS will deny your green card application on health grounds unless you obtain a medical waiver.
Waivers are available for some Class A conditions, though the process adds time and complexity to your case. You will need to consult an immigration attorney about waiver eligibility for your specific condition.
Class B Findings and Your Green Card Eligibility
If the civil surgeon documents a Class B condition—such as latent TB, diabetes, or HIV—you are not inadmissible on health grounds, though the condition may trigger other grounds of inadmissibility, such as public charge. Class B conditions are documented but do not prevent green card approval based solely on the medical exam.
However, a Class B finding may affect other parts of your case; for example, some Class B conditions could implicate the "public charge" rule if USCIS believes you are unlikely to be self-supporting. Discuss any Class B findings with your immigration attorney to understand whether they could affect your specific case.
The One-Application Limit on Form Validity
Form I-693 signed on or after November 1, 2023, is valid only for the specific application it is submitted with; if that application is withdrawn or denied, the form becomes invalid and a new medical exam is required for any future green card application. This is a hard deadline. If your I-485 is denied or you withdraw it after submitting Form I-693, you will need a new medical exam and a new Form I-693 for any subsequent green card application.
Schedule your civil surgeon appointment only after you are completely ready to submit your I-485 application—do not do the medical exam months in advance. The form's validity to that specific application means any delay or change in your immigration case could render it useless.
Frequently Asked Questions
Can my regular doctor complete Form I-693?
No. Only a USCIS-designated civil surgeon can complete and sign the form, regardless of your doctor's licenses or experience.
What if my Form I-693 shows a Class B condition?
Class B conditions do not block a green card on health grounds, but they are documented and may affect other parts of your case, such as public charge determinations.
How long is Form I-693 valid?
Forms signed after November 1, 2023, are valid only for the specific application they are submitted with. If that application is withdrawn or denied, a new exam is required.
What vaccines does Form I-693 require?
The form requires proof of all age-appropriate vaccines per CDC guidelines, which vary by age and citizenship status.