The Complete I-693 Guide (2026)

What is Form I-693?

Form I-693 is the standardized medical examination report that almost every applicant for U.S. permanent residency (a "green card") must submit. It documents that you've had the required physical examination, lab tests, and vaccinations to qualify for admission to the United States on public-health grounds. USCIS does not accept medical exams from family physicians or general practitioners — only from a doctor specifically designated by USCIS as a "Civil Surgeon."

When do you need it?

You need a Form I-693 if you're applying for adjustment of status (Form I-485) inside the United States. The I-693 is filed together with your I-485, or later in response to a USCIS Request for Evidence. If you're applying for an immigrant visa at a U.S. consulate abroad, you complete a similar but separate exam called Form DS-2054 with an embassy-approved Panel Physician — not an I-693.

What's on the I-693?

The Civil Surgeon fills out four sections during your appointment:

1. Applicant Information & History — basic biographic info plus your medical history
2. Physical Examination & Lab Tests — head-to-toe physical, blood draws for syphilis serology (ages 15+), tuberculosis IGRA blood test (ages 2+), gonorrhea NAAT (ages 18-24 or by risk), urinalysis
3. Vaccination Record — review of your prior vaccinations + administration of any missing required doses
4. Mental Health Screening — brief verbal interview screening for harm-associated disorders

How much does it cost?

Our network's average I-693 cost is $295 for the base medical examination, with vaccinations billed at cost (no admin fee). Rush option (24-hour turnaround vs the standard 5 business days) typically adds $95. Total out-the-door cost for a typical patient with up-to-date vaccinations is $295; for a patient needing 4-5 missing doses it's typically $650-$800.

How long is the I-693 valid?

For I-693s signed November 1, 2023 or later, validity is indefinite provided the Civil Surgeon signed within 60 days of your I-485 filing or while your I-485 was pending. This is a major change from the old 2-year shelf life. Source: USCIS Policy Manual update PA-2023-26.

Common mistakes (and how to avoid them)

• Opening the sealed envelope. USCIS rejects opened envelopes outright. Always ask for a duplicate open copy at your appointment — free at most network providers.
• Using a family doctor. Only USCIS-designated Civil Surgeons can perform the I-693.
• Skipping vaccinations to save money. Missing doses without a valid waiver delay your case.
• Missing translated vaccination records. Get records in non-English languages translated by a certified translator in advance.

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