United States · USCIS

Form I-693 Medical Examination

The required medical exam for every adjustment-of-status (I-485) green card application. Performed by a USCIS-designated Civil Surgeon, sealed in a tamper-evident envelope, ready to file with your I-485.

What is Form I-693?

A standardized medical examination required by USCIS.

Form I-693, Report of Medical Examination and Vaccination Record, is the document a USCIS-designated Civil Surgeon fills out after performing your immigration medical exam. It is required for almost every adjustment-of-status (I-485) case. Without a valid sealed I-693, USCIS will issue a Request for Evidence (RFE) and your green card application is paused.

At a glance

Cost: $295 (all-in)
Time at clinic: 45 minutes
Sealed envelope ready: 5 business days
Validity: indefinite once filed (per PA-2023-26)
Same-day vaccinations: yes, at cost
Rush option: +$95 (24 hr)

What's included

Physical examination

Height, weight, vital signs, head-to-toe physical including cardiovascular, respiratory, abdominal, neurological, and skin assessment.

Tuberculosis screening

IGRA blood test for everyone 2+. Negative results in 24-72 hours. Chest X-ray coordinated same week if IGRA positive.

Syphilis serology (15+)

Required blood test for everyone 15 and older. Single venipuncture draw.

Gonorrhea screening (18-24)

Urine NAAT test, routine for ages 18-24 and others with risk factors.

Mental health screening

Brief verbal interview, not a psychiatric evaluation. Only harm-associated disorders trigger Class A status.

Vaccinations on the same visit

Civil Surgeon reviews your vaccination record and administers any required missing doses. View vaccine list →

Your visit, step by step

Check-in (5 min) — Show your government photo ID + USCIS receipt notice. We verify the chart and pull your prior records if you've been a patient before.
Patient interview (10 min) — Medical history, mental-health screening, substance-use screening. Conducted in English, Spanish, or Mandarin at our owned clinics.
Physical exam (15 min) — Civil Surgeon performs the head-to-toe assessment per USCIS Technical Instructions.
Blood draws (5 min) — IGRA (TB), syphilis serology, gonorrhea NAAT (18-24 or by risk). Single venipuncture for all three.
Vaccinations (5-20 min) — Any required doses administered on the same visit. We stock the full CDC Civil Surgeon schedule.
Sealed envelope (5 business days) — Lab results come back, Civil Surgeon completes Form I-693, signs, dates, and seals the envelope with the official USCIS label. You can pick it up or we'll mail it certified.

Frequently asked questions

How long is my 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. Pre-Nov-2023 I-693s have a 2-year shelf life from the signature date. (Source: USCIS Policy Manual update PA-2023-26.)

Can I open the sealed envelope to check what's inside?

No. Doing so invalidates the I-693 and forces a new $295 examination. USCIS rejects opened envelopes outright. If you or your attorney want to see the results for your records, ask the Civil Surgeon for a duplicate open copy at your appointment — we provide one free of charge.

Do I need to fast before my exam?

No. None of the I-693 blood tests require fasting.

What if I don't have my vaccination records?

Bring whatever you have — childhood records from your home country, school immunization records, employer records — and we'll evaluate. Missing vaccinations can be administered same-day (charged at cost). For records in a non-English language, we can refer you to a certified translation service ($50-$120 per page) or you can have them translated in advance.

My USCIS interview is in two weeks. Can you do a rush?

Yes. Our rush option is +$95 and we seal the envelope within 24 hours of your exam (provided your lab results return normal within that window). Same-week appointments are usually available even without rush.

Ready to book?

Same-week appointments. Sealed envelope in 5 business days. Transparent pricing — $295 base I-693 exam.

Book Your Appointment →