USCIS Medical Exam (I-693): Complete Guide
Everything about the immigration medical exam — finding a civil surgeon, required vaccinations, costs, how long it stays valid, and filing Form I-693 with your I-485.
Have a case with USCIS? Check my case free
What Is the I-693 Medical Exam?
Form I-693, Report of Medical Examination and Vaccination Record, is a required medical examination for anyone applying for adjustment of status (I-485) to become a U.S. permanent resident. The exam ensures that applicants do not have any communicable diseases that would pose a public health risk and verifies that required vaccinations are up to date.
Finding a Civil Surgeon
The medical exam must be performed by a USCIS-designated civil surgeon — your regular doctor cannot complete this form. Use the USCIS Find a Doctor tool to locate designated civil surgeons near you. Prices vary significantly, so it is worth calling several offices for quotes.
What Happens During the Exam
- Physical examination: General health assessment including height, weight, blood pressure, vision, and hearing
- Mental health screening: Brief assessment for mental health conditions that could pose a risk
- Lab tests: a tuberculosis blood test (IGRA) for applicants 2 and older, and a blood test for syphilis and a urine test for gonorrhea for adults in the age ranges the CDC sets
- Chest X-ray: Required if the TB blood test is positive
- Vaccination review: The doctor reviews your vaccination records and administers any missing required vaccines
Required Vaccinations
The CDC-mandated vaccination requirements for immigration include:
- Mumps, Measles, Rubella (MMR)
- Polio
- Tetanus, Diphtheria, Pertussis (Tdap)
- Hepatitis A and Hepatitis B
- Varicella (chickenpox)
- Influenza (seasonal — only required during flu season)
- Pneumococcal, Rotavirus, Meningococcal, Hib (age-appropriate)
USCIS stopped requiring the COVID-19 vaccine on January 22, 2025. The civil surgeon follows the CDC's current list for your age, so ask them which vaccines you still need.
Tip: Bring all existing vaccination records to your appointment. Every vaccine you can prove you already received is one less you need to pay for.
Costs
Civil surgeons set their own prices, so the exam fee varies by doctor and city, and vaccinations and lab tests are often billed separately. Ask several offices for a quote that lists the exam, the tests and each vaccine. Many health insurance plans do not cover the immigration exam itself, but some cover the vaccinations. Call your insurance provider to check. This is the doctor's charge, not a USCIS fee.
Validity and Timing
Since December 2, 2024, if you need an I-693 you must file it together with your I-485 (in sealed form, as the civil surgeon gives it to you); USCIS may reject an I-485 filed without it. Since June 11, 2025, an I-693 is generally valid only while the application it was filed with is pending. If that application is denied or withdrawn, or you file a new one later, you need a new exam. USCIS may also ask for a new or updated I-693 if it has reason to.
Sources: USCIS: Form I-693 and its Policy Manual chapter.
Frequently Asked Questions
Can I use my regular doctor for the immigration medical exam?
No. Only USCIS-designated civil surgeons can complete Form I-693. Use the USCIS Find a Doctor tool to locate one near you.
What if I have a positive TB test?
A positive TB blood test or skin test does not automatically disqualify you. You will need a chest X-ray to check for active tuberculosis. If the X-ray is clear, you may be cleared with a diagnosis of latent TB. If active TB is found, you must complete treatment before your I-485 can be approved.
Can I send the I-693 later instead of with my I-485?
Not for an I-485 filed on or after December 2, 2024. If you need an I-693, it goes in the same package as the I-485, and USCIS may reject an I-485 filed without it. Check the I-485 instructions for the few cases that differ (some applicants file only the vaccination record).
See your own case, explained.
See every step USCIS has recorded for your case, in plain English: your timeline, silent updates, and what usually comes next for cases like yours.
Check my case freeWe are immigration applicants and technologists who built CaseStatusAPI to help others navigate the USCIS process with transparency. Our guides are informed by firsthand experience, community feedback, and deep analysis of USCIS internal API data.
Learn more about us