Required medical exam completed by a USCIS-approved civil surgeon.
Anyone filing Form I-485 to adjust status to lawful permanent resident.
Form I-693 must be completed by a USCIS-designated civil surgeon. The sealed envelope must be submitted to USCIS — you cannot open it.
Find a USCIS-approved civil surgeon at uscis.gov
Schedule and attend the medical exam
Get required vaccinations if not already completed
Civil surgeon seals the I-693 envelope — do not open it
Submit the sealed envelope with your I-485 or bring it to your interview
Physical examination, including a review of your medical history
Screening for certain communicable diseases of public health significance (such as tuberculosis)
Verification that required vaccinations are up to date, or administration of missing ones
Mental health and substance-related disorder screening, as applicable
Bring your vaccination records if you have them — this can prevent repeat vaccinations you've already had
Bring a government-issued photo ID and, if available, your prior immigration documents
Complete the exam close to your I-485 filing — results are generally valid for a limited window, so timing matters
Opening the sealed envelope. This is the single most common error — an opened envelope is often rejected outright and requires a repeat exam.
Completing the exam too early. If too much time passes between the exam and your I-485 decision, USCIS may require an updated exam.
Using a civil surgeon who isn't USCIS-designated. Only exams from USCIS-approved civil surgeons are accepted — always verify designation status before your appointment.
How much does the exam cost? Civil surgeons set their own fees, so cost varies significantly by provider and location — it's worth calling a few offices to compare.
What if I'm missing a required vaccination? The civil surgeon can typically administer missing vaccines during the same visit, sometimes for an additional fee.
Do I need a new exam if my I-485 takes years to process? Possibly — if your case is pending long enough, USCIS may request updated results at your interview.
📄 Official Form on USCIS.gov →Use ClearPath's free tools to check your own situation
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