If you're filing for a green card, USCIS requires Form I-693, the medical examination and vaccination record that proves you meet United States public health standards. Before booking your Immigration Medical Exam, here's Form I-693 explained: who signs it, what a civil surgeon checks, and why a regular doctor can't complete it.
By The Medical Team at Accelerate Health Clinics, Licensed medical providers, San Diego
What Is Form I-693 and Why Does USCIS Require It?
Form I-693, the Report of Medical Examination and Vaccination Record, documents that a green card applicant doesn't have a health condition that would make them inadmissible to the United States.
USCIS uses it to confirm two things: that you don't have any communicable diseases of public health significance, such as untreated active tuberculosis, and that your vaccination records meet the immunization requirements set for permanent residents.
Most applicants submit Form I-693 alongside Form I-485, the application to register permanent residence or adjust status, though it can also come up during a green card interview or in response to a request from USCIS. Because the form protects public health at a national level, it isn't optional paperwork.
An adjustment of status application generally can't move forward without a complete, properly signed medical examination and vaccination record on file.
A civil surgeon is a physician USCIS has specifically designated to perform immigration medical exams and complete Form I-693. Doctors don't earn this designation automatically. They apply directly to USCIS, meet minimum experience and licensing requirements, and are approved individually, which is why the designation is a legal requirement separate from a standard medical license.
This matters because your regular primary care doctor, however qualified, cannot sign Form I-693 unless USCIS has designated them as a civil surgeon. USCIS built this system so every I-693 nationwide follows the same format and standards, which makes the form easier for immigration officers to evaluate consistently.
If your doctor isn't on USCIS's civil surgeon list, an exam they perform won't be accepted with your green card application, no matter how thorough it is.
What the Civil Surgeon Checks During Your I-693 Medical Examination
A civil surgeon's medical examination covers more ground than a routine physical. Expect a review of your medical history, a physical exam, a mental health and substance use screening, and a check for any communicable diseases of public health significance.
Applicants aged 15 and older are also generally screened for tuberculosis and syphilis, and the civil surgeon reviews your vaccination status against the current requirements. The civil surgeon documents every finding directly on Form I-693 and doesn't share a diagnosis or opinion beyond what USCIS needs for your case.
If something needs follow-up, such as an additional test or a vaccine series that isn't complete, the civil surgeon notes it so you know exactly what's outstanding before you submit your paperwork.
Vaccinations and Records You Need Before Your Civil Surgeon Appointment
Before your appointment, gather every immunization record you can find: childhood shot records, school or employer vaccination records, prior lab work showing immunity, and any documentation from past civil surgeon or physician visits. Your civil surgeon uses this history to determine which vaccines, such as MMR, Tdap, varicella, or others the CDC recommends for your age group, you still need.
Without documentation, expect your civil surgeon to order blood tests called titers to check for existing immunity, or to administer vaccines you may have already received, which adds time and cost to your visit.
Applicants who arrive with organized vaccination records typically move through the exam faster, since the civil surgeon can get Form I-693 explained and signed in a single visit instead of scheduling a follow-up appointment.
Form I-693 Cost and Timeline: What to Expect
Form I-693 cost varies by clinic and depends on which vaccines, titers, or tests you still need beyond the base exam, so it's worth confirming current pricing before your visit rather than assuming a flat rate. Most applicants complete the exam in a single appointment, though anyone needing catch-up vaccinations or lab work may need a short follow-up visit to finish their vaccination records.
Because the civil surgeon must sign Form I-693 close to when you file, scheduling your exam a few weeks before filing your adjustment of status application generally works better than completing it too far in advance. You can Book Now to confirm appointment availability and get current pricing for your civil surgeon exam.
How Long a Completed Form I-693 Stays Valid
Getting Form I-693 explained accurately upfront, including its validity window, helps you avoid redoing the exam later. Under current USCIS policy, a properly completed Form I-693 submitted with your adjustment of status application is generally treated as valid for the life of that case, as long as the civil surgeon signs it no more than 60 days before you file.
This replaced an older rule that treated the form as expiring two years after the exam date. You'll typically file Form I-693 together with your adjustment of status application, so its validity window matters most in the months right after you submit.
Because USCIS updates this kind of guidance periodically, confirm the current standard with your civil surgeon or immigration attorney before your appointment, especially if your case has been pending for an extended period.
Form I-693 Explained: What Happens When It's Incomplete or Missing Vaccinations
An incomplete Form I-693, whether it's missing a required vaccination, a signature, or a section the civil surgeon skipped, can trigger a Request for Evidence from USCIS, which delays your case while you get the missing piece completed and resubmitted.
Your civil surgeon seals the completed form in an envelope, and that seal should stay intact until USCIS or an officer opens it, since a broken seal can also raise questions. The good news is that most gaps are fixable.
If you're missing a vaccination, your civil surgeon can administer it during a follow-up visit, and if a test result was still pending when the form was submitted, you can typically provide the completed information afterward rather than starting the entire medical examination over.
Frequently Asked Questions
Can my primary care doctor complete Form I-693, or does it have to be a civil surgeon?
No. Only a physician USCIS has specifically designated as a civil surgeon can complete and sign Form I-693, even if your regular doctor is licensed and experienced. USCIS maintains this separate designation so the medical examination and vaccination record follows the same standard nationwide, so an exam from a non-designated doctor won't be accepted with your application.
How do I find a USCIS-designated civil surgeon near San Diego?
USCIS publishes civil surgeon information and a searchable directory by ZIP code on its website, and several San Diego clinics, including ours, hold this designation. Confirm a provider's status is current before booking, since civil surgeon designations can lapse, and ask whether they handle the physical exam and vaccination review in one appointment.
Do I need to bring vaccination records to my civil surgeon visit?
Yes. Bring any vaccination records, immunization history, or prior lab results you have, since your civil surgeon uses them to determine which vaccines you still need and to avoid repeat vaccination records or unnecessary testing. Without documentation, the civil surgeon may need to order titers or re-administer vaccines you may have already received.
Can I submit Form I-693 separately from my green card application?
In most cases, Form I-693 should be submitted with your adjustment of status application, though USCIS may request it separately in some circumstances, such as during a Request for Evidence. Filing it upfront generally avoids delays, since an officer typically can't approve your case until a complete, current medical examination and vaccination record is on file.
What happens if I don't pass part of the civil surgeon's medical exam?
A missed or incomplete requirement, such as an outstanding vaccination or a pending test, doesn't automatically mean denial. Your civil surgeon can note the item, and you can complete it before your interview or in response to a Request for Evidence, though resolving it before you submit is usually faster than waiting for USCIS to ask.
Schedule Your Immigration Medical Exam in San Diego
Our civil surgeons can complete your medical examination, vaccination record, and Form I-693 paperwork in one visit, so your green card application keeps moving without unnecessary delay. Contact our office to check availability and confirm what to bring to your appointment.
Questions about any of this? A free consultation with a licensed provider is the fastest way to a real answer.
