{"id":7093,"date":"2026-11-13T04:47:48","date_gmt":"2026-11-13T04:47:48","guid":{"rendered":"https:\/\/abogadaadrianagomez.com\/resources\/adjustment-of-status\/i-693-medical-exam-adjustment-of-status\/"},"modified":"2026-11-14T07:23:40","modified_gmt":"2026-11-14T07:23:40","slug":"i-693-medical-exam-adjustment-of-status","status":"publish","type":"page","link":"https:\/\/abogadaadrianagomez.com\/resources\/adjustment-of-status\/i-693-medical-exam-adjustment-of-status\/","title":{"rendered":"Form I-693 Medical Exam for Adjustment of Status Explained"},"content":{"rendered":"\n
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Adjustment of Status | AG Immigration Law P.A.<\/p>

Form I-693 Medical Exam: Preparing Your Green Card Case<\/h1>

Learn what the exam involves, which records to gather, and how to keep this step on track alongside the rest of your filing.<\/p>

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How our office supports your adjustment of status case<\/h2>\n

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A focused practice<\/h3>

AG Immigration Law P.A. focuses on removal defense, adjustment of status, family petitions, naturalization, removal of conditions on green cards, waivers and BIA appeals.<\/p><\/div>

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Organized paperwork<\/h3>

Our team helps keep your medical exam records, vaccination documents and other filing materials organized in one place.<\/p><\/div>

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Direct communication<\/h3>

Reach our office by phone, through our contact form or on WhatsApp with questions about your Form I-693 and your case.<\/p><\/div>

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Support from our staff<\/h3>

Our assistants and office staff help track each step so you know where your case stands.<\/p><\/div><\/div>\n\n<\/div>\n\n\n

By Adriana Gomez \u00b7 Published November 12, 2026<\/p>\n\n

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Planning to apply for a green card from inside the United States? You may wonder whether a medical exam is part of the process.<\/p>\n

Yes. Most people who file for adjustment of status need an I-693 medical exam and vaccination record. The exam is documented on Form I-693. In the United States, except for Public Health Service officers, only a physician designated by USCIS as a civil surgeon may conduct the examination and complete Form I-693.<\/p>\n

Short Answer: Most Adjustment of Status Applicants Need Form I-693<\/h2>\n

Yes, most adjustment of status<\/a> applicants need Form I-693, the Report of Immigration Medical Examination and Vaccination Record. Adjustment of status is the process of getting a green card from inside the United States. Under 8 CFR 245.5<\/a>, an applicant for adjustment of status shall be required to have a medical examination by a designated civil surgeon, whose report setting forth the findings of the applicant’s mental and physical condition shall be incorporated into the record. A medical examination is not required of an applicant who entered the United States as a nonimmigrant spouse, fianc\u00e9, or fianc\u00e9e of a United States citizen, or as the child of such an alien, if the applicant was medically examined before, and as a condition of, the issuance of the nonimmigrant visa, provided the examination occurred not more than 1 year prior to the date of application for adjustment of status.<\/p>\n

The form shows whether you have any health-related reasons you could be inadmissible. The USCIS medical review policy<\/a> says applicants who must show admissibility must submit Form I-693.<\/p>\n

Some conditions are Class A. These make a person inadmissible and ineligible for adjustment. The USCIS Policy Manual<\/a> lists health-related conditions that include a communicable disease of public health significance per HHS regulation, a failure to present documentation of having received vaccinations against vaccine-preventable diseases, a present or past physical or mental disorder with associated harmful behavior or harmful behavior that is likely to recur, and drug abuse or addiction. Class B conditions are serious or permanent. They may not bar you, but they are recorded on the form.<\/p>\n

Certain K nonimmigrants, meaning the spouse, fianc\u00e9 or fianc\u00e9e of a U.S. citizen or the child of such an alien as defined in section 101(a)(15)(K), do not repeat the exam if they had it before getting their visa, and it was not more than one year before filing.<\/p>\n\n

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If your civil surgeon exam is booked, or USCIS asked for a Form I-693 before your I-485 is filed, our team can review the package with you before it goes in. Talk it through with our team — we can walk you through how a situation like yours is usually handled and what your options are.<\/p>

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Who Completes Form I-693 and When It Is Filed<\/h2>\n

A USCIS-designated civil surgeon completes Form I-693 for applicants inside the United States. Panel physicians abroad handle immigrant visa and refugee applicants outside the country, according to USCIS guidance on medical examinations<\/a>. The doctor you pick must be designated to perform the exam; most applicants use a civil surgeon on USCIS’s list, though a U.S. Public Health Service medical officer may also conduct it. The USCIS civil surgeon list policy<\/a> explains that USCIS keeps and updates this list.<\/p>\n

The civil surgeon signs the form and seals the results. You then file the form with your adjustment application. The I-485 filing rule<\/a> says the application is submitted on Form I-485, with the required fee.<\/p>\n

Timing matters. A Form I-693 signed on or after November 1, 2023 can be used only for the application it supports, and only while that application is pending. A June 2025 policy update<\/a> confirms that a Form I-693 is generally valid only for the application it was submitted with. An older exam may not cover a new filing.<\/p>\n

The same medical exam rule still applies.<\/p>\n

Step 1: Gather Medical Records, Vaccination History, and Proof of Appointments<\/h2>\n

Before the exam, gather your vaccination records. Bring any list of past diagnoses, treatments, and hospital stays you have. These records help you answer the civil surgeon’s questions accurately and completely.<\/p>\n

Use the current form. The USCIS medical review policy<\/a> says that in most cases only the edition in use when the civil surgeon signs Form I-693 is acceptable. Older editions are generally not accepted because they may lack required information. Ask your civil surgeon which edition they use.<\/p>\n

Keep copies of everything. Save your appointment confirmations, a copy of the completed form, and any letters from the civil surgeon. You will want a full record for your own file and for your filing package.<\/p>\n

A common mistake is bringing partial records. A missing vaccine record can cause a delay later. Gather what you can before the appointment, even if you think it is minor.<\/p>\n

Step 2: Complete the Required Vaccinations<\/h2>\n

The federal inadmissibility statute<\/a> says an applicant for adjustment who has not shown vaccination documentation is inadmissible. The statute lists mumps, measles, rubella, polio, tetanus and diphtheria, pertussis, Haemophilus influenza type B, and hepatitis B. Other vaccines that the Centers for Disease Control and Prevention (CDC) has determined are in the interest of public health also count.<\/p>\n

COVID-19 is different. USCIS stopped issuing requests for evidence, notices of intent to deny, or denials based on missing COVID-19 documentation as of January 20, 2025. COVID-19 is different.<\/p>\n

Some vaccines may not be medically appropriate for you. If the civil surgeon certifies that a vaccine is not medically appropriate for one or more of the specified reasons, such as it not being flu season, the officer may grant a blanket waiver for that vaccine. You do not file a separate form for this waiver. The USCIS vaccine requirement policy<\/a> explains that the civil surgeon’s note is enough.<\/p>\n

A separate religious or moral waiver is also possible. Whether this fits your situation depends on your facts. Talk through your options before you decide.<\/p>\n

Start early. According to USCIS Policy Manual guidance on immigrant vaccination requirements<\/a>, when an applicant was required to obtain the flu vaccine at the time of the medical examination (the date of the civil surgeon’s certification governs) but the flu vaccine annotation is missing, the officer should only issue a Request for Evidence (RFE) if it is still the same flu season and if it is reasonable to expect that the applicant will be able to obtain the flu vaccine within the time frame of the RFE.<\/p>\n

Step 3: Attend the Exam With a USCIS-Designated Civil Surgeon<\/h2>\n

At the appointment, the civil surgeon reviews your medical history and does a physical exam. The civil surgeon also reviews your vaccination record. The findings on your mental and physical condition go on the form, as the 8 CFR 245.5<\/a> rule describes.<\/p>\n

Answer history questions honestly. The civil surgeon records what they find. Officers review the form for compliance with the CDC instructions in effect on the day the civil surgeon signed it.<\/p>\n

If the civil surgeon diagnoses a Class A condition and you refuse treatment, the form still gets signed. The officer then treats you as inadmissible and asks you to request a waiver, if one is available, under the USCIS medical review policy<\/a>.<\/p>\n

Some findings need more testing or follow-up before the form is complete. Ask the civil surgeon what follow-up they recommend and when. Keep notes on each visit.<\/p>\n

Officers should not ask for a new or updated Form I-693 because of a requirement that did not apply on the day the civil surgeon signed, unless the CDC specifies otherwise. That protects you from paying for tests you were never required to take.<\/p>\n

Step 4: Keep the Sealed Envelope Closed and File With the I-485<\/h2>\n

The form goes into a sealed envelope, as the form instructions describe. Keep it sealed. Do not open or retype the results yourself. The civil surgeon’s findings must stay exactly as the doctor recorded them.<\/p>\n

The filing rule for adjustment of status<\/a> requires that the application be accompanied by the appropriate fee as explained in the instructions to the application.<\/p>\n

Review the full package before you submit it. The USCIS filing rule<\/a> says a benefit request that does not follow the statutes, regulations, or form instructions may be rejected or denied. A rejection cannot be appealed. Missing initial evidence also matters. If required evidence is missing, the processing clock starts over when the evidence arrives.<\/p>\n

Keep a complete copy of the packet for your records. If USCIS sends a request for evidence, the processing time pauses until you respond. Reply on time, and keep proof of what you sent.<\/p>\n\n

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Not sure what your next step is?<\/h3>

Talk it through with our team — we can walk you through how a situation like yours is usually handled and what your options are.<\/p>

Schedule a consultation<\/a><\/div><\/div>\n<\/div>\n

When Medical History and Vaccination Questions Need Careful Review<\/h2>\n

Some cases need a closer look before filing. These include a complex medical history, a vaccination gap, a Class A finding, or an older Form I-693 that may no longer match your filing date.<\/p>\n

A Class A finding does not always end the case. The form records it, and you may need to request a waiver where one is available. Whether a waiver fits depends on the facts of your case, and the outcome is not something anyone can promise in advance.<\/p>\n

Also check whether your exam was signed on or after November 1, 2023. The June 2025 update means an earlier form may not support a new application. If your exam is older, ask whether a new one is needed before you file.<\/p>\n

Other parts of your case may also matter. Waivers of inadmissibility, family petitions, and adjustment in removal proceedings each have their own rules. Those topics are covered in our other practice pages, which focus on removal defense, adjustment of status, family petitions, naturalization, removal of conditions on green cards, waivers, and BIA appeals.<\/p>\n

Key Takeaways<\/h2>\n