Green Card Medical Exam & Form I-693: What to Expect in 2026

Green Card Medical Exam & Form I-693: What to Expect in 2026

For many people applying for adjustment of status, an immigration medical examination is an important part of the green card process. Form I-693, Report of Immigration Medical Examination and Vaccination Record, documents the examination and vaccination information for USCIS. The examination must generally be completed by a physician designated by USCIS as a civil surgeon.

What Is Form I-693?

Form I-693 reports the results of an immigration medical examination to USCIS. The examination is used to help establish whether an applicant is inadmissible on health-related grounds under the immigration laws.

USCIS’s current Form I-693 instructions explain that most applicants seeking adjustment of status must submit the form completed by a designated civil surgeon, although special rules and exceptions apply to some categories, including certain K nonimmigrants, refugees, and asylees.

Who Performs the Green Card Medical Exam?

The examination in the United States must be performed by a USCIS-designated civil surgeon. A regular primary-care physician cannot simply complete Form I-693 unless that physician is also authorized by USCIS as a civil surgeon.

USCIS provides a tool to find a designated civil surgeon.

What Happens During the Medical Exam?

The exact appointment can vary based on the applicant’s age, medical history, vaccination history, and the requirements that apply at the time of the examination. The civil surgeon follows the applicable CDC technical instructions and USCIS requirements.

The appointment may involve:

• Review of your medical and vaccination history
• A physical examination and other assessments required under the applicable technical instructions
• Review of vaccination records and identification of vaccines or follow-up that may be required
• Laboratory testing or other procedures required by the current technical instructions and the applicant’s circumstances
• Completion, signature, and certification of Form I-693 by the civil surgeon

The civil surgeon may also explain whether additional testing, vaccination, or follow-up is needed before the form can be completed.

What Should You Bring to the Appointment?

Bring the documents and information the civil surgeon’s office requests. Depending on the office and your circumstances, this may include:

• Passport or other government-issued photo identification
• Your vaccination records and other relevant medical records
• Information about current medications and significant medical history
• Documentation from a prior immigration medical examination, when relevant
• Any other records the civil surgeon requests before the appointment
• A payment method accepted by the civil surgeon’s office

Call the civil surgeon’s office before the appointment to confirm exactly what it wants you to bring. Requirements can differ depending on your circumstances.
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Keep the Sealed Form I-693 Envelope Closed

After the civil surgeon completes Form I-693, the form and required supporting documentation are placed in a sealed envelope for submission to USCIS. USCIS instructions state that the applicant should not open or alter the sealed envelope. The civil surgeon should also provide a copy of the completed Form I-693 for the applicant’s records.

If USCIS receives an envelope that has been opened or altered, it may reject the form. Keep the USCIS submission envelope sealed until you submit it as instructed.

When Should You Complete the Medical Exam?

Timing matters because Form I-693 is tied to the immigration benefit application for which it is submitted. USCIS announced in December 2024 that certain adjustment-of-status applicants must submit Form I-693 with Form I-485, rather than waiting for USCIS to request it later.

On June 11, 2025, USCIS changed its policy on I-693 validity. The change applies to any Form I-693 signed by a civil surgeon on or after November 1, 2023. Under the current policy, a Form I-693 is generally valid only while the immigration benefit application with which it was submitted remains pending. If that application is denied or withdrawn, the I-693 is no longer valid for that application. A new I-693 is generally required for a subsequent benefit application.

This means older online advice describing Form I-693 as having a simple, stand-alone validity period can be misleading. Always check the current USCIS instructions that apply when you file.

What About K-1 Visa Holders?

K-1 fiancé(e) visa holders have special rules because they may already have completed an immigration medical examination overseas before entering the United States.

USCIS’s current I-693 instructions state that a K-1 or K-2 applicant who had the required overseas examination may not need another immigration medical examination when adjusting status if the applicable conditions are satisfied, including filing Form I-485 within one year of the overseas examination and meeting the relevant medical requirements.

Because the rule depends on the timing and results of the overseas examination, K-1 applicants should not automatically schedule a second medical exam without first checking whether the prior examination can be used.

What If USCIS Requests a New Medical Exam?

If USCIS sends a notice requesting additional medical evidence, read the notice carefully and follow its instructions. A new examination or additional documentation may be required depending on the reason USCIS cannot use the medical evidence already in the record.

If the issue involves an older examination, a previously denied or withdrawn application, or a complicated medical-documentation question, consider obtaining legal guidance before deciding how to respond.

Practitioners have also reported that, as of September 2026, USCIS has issued requests for evidence demanding a new medical examination even where a previously submitted Form I-693 should still be valid under the June 2025 rule. In practice, the agency may request fresh exams more often than the validity rule alone would suggest, so follow the notice you receive and consider attorney review before scheduling a new exam.

How Much Does a Green Card Medical Exam Cost?

USCIS does not set one nationwide price for the civil-surgeon examination. Fees vary by office, location, vaccinations, laboratory testing, and other services that may be required.

Before scheduling, ask the civil surgeon’s office for its examination fee and whether additional charges may apply for vaccinations, laboratory work, or follow-up visits.

Common Medical Exam Mistakes to Avoid

• Using a physician who is not a USCIS-designated civil surgeon
• Arriving without vaccination or other medical records that are available
• Signing Form I-693 before the civil surgeon instructs you to sign it
• Opening or altering the sealed envelope intended for USCIS
• Relying on outdated information about Form I-693 validity
• Assuming every immigration category follows exactly the same medical-exam rules
• Scheduling a second examination as a K-1 applicant without checking whether the overseas examination can still be used