One key component of the process for gaining a green card (permanent residence) in the United States is the medical exam. The medical exam is not an ordinary check-up, but instead a key process in ensuring applicants meet qualifications based on health standards, as set by American immigration law. The key form to this process is Form I-693, Report of Medical Examination and Vaccination Record.
Here on this blog, we will take you through everything you should know about the medical examination for a green card, including what the I-693 form is, who needs it, what to do when you take the exam, and how to avoid mistakes.
What is the Medical Exam for a Green Card?
The medical examination on a green card is mandatory for the majority of family-based, employment-based, and other types of applicants for permanent residence in the U.S. The principal requirement is to determine that the applicant is not inadmissible to the U.S. on public health grounds.
The test measures for
- Communicable diseases of public health significance (e.g., tuberculosis)
- Physical or mental illness related to risky behavior
- Substance abuse or addiction
- Documentation of immunization against specific illnesses
This screening ensures that the newly admitted residents will not pose a health risk to the general population.
What is Form I-693?
Form I-693, or officially the Report of Medical Examination and Vaccination Record, is the form used by the U.S. Citizenship and Immigration Services (USCIS) to record the results of the medical examination that green card applicants are required to undergo.
It must be signed and completed by a USCIS-approved civil surgeon, stamped, and then placed in an envelope to be mailed to USCIS. The applicant must not open the envelope—doing so invalidates it.
Who needs to file Form I-693?
You have to submit Form I-693 if you’re requesting a permanent resident (green card) status in the United States. Usually, you do this when you’re submitting Form I-485.
Those applying from outside the U.S. will undergo the same medical examination at an embassy or consulate of the U.S. outside the U.S. by a panel physician instead of a civil surgeon.
When to File Form I-693?
You may submit Form I-693:
- With your I-485 application (to avoid delay)
- Once USCIS asks for it (via a Request for Evidence or RFE)
Pro Tip: USCIS prefers receiving Form I-693 within 60 days of the civil surgeon’s signature, and the form remains valid for 2 years after submission (as of the current policy). To minimize delays, it’s smart to have the medical exam done shortly before filing the green card application.
How to Prepare for a Green Card Medical Exam?
Here’s what to bring for your stay:
- Government-issued photo identification (passport, driver’s license, or state ID)
- Immunization records
- Form I-693 (do NOT complete it yourself)
- A list of drugs that you are taking
- Medical history (particularly mental health, previous hospitalizations, or chronic disease)
- Bill for the evaluation (fees will vary).
Tip: You don’t complete the form personally. The civil surgeon will fill it out after your examination.
What Is Done During Medical Evaluation?
This is what normally occurs following a green card medical examination:
Physical Examination
The civil surgeon shall perform a general physical examination, which includes:
- Stature, mass, arterial pressure
- Eye, ear, nose, and throat screening
- Lung, cardiac, and abdominal assessment
Tuberculosis (TB) Screening
All candidates 2 years and above should be screened for TB. In the event of a positive test, a chest X-ray could be advised.
Vaccination Review
You will be required to provide evidence of immunizations, such as:
- MMR (measles, mumps, rubella)
- Tetanus-diphtheria
- Hepatitis B
- Varicella
- COVID-19
If you lack any of the vaccines required, the civil surgeon can administer them during the consultation.
Mental Health and Substance Use Assessment
Questions can be about any history of drug abuse or mental illness. Openness is a must; however, abuse of controlled substances or some untreated psychological diseases can affect one’s suitability.
How much does it cost?
Prices depend on the clinic, but are typically between $200 and $500. This does not necessarily cover vaccinations, which may be charged separately. Verify with the clinic in advance for a fixed cost and if they take insurance (they typically do not).
How to Locate a USCIS-Approved Civil Surgeon
You must use a civil surgeon authorized by USCIS. To find one:
- Visit the USCIS Civil Surgeon Locator Tool
Do not use an ordinary primary care physician unless they are USCIS-approved.
What’s Next after the Exam?
The civil surgeon will hand over:
- A sealed envelope with the completed I-693 Form
- A copy of your own documents.
Final Thoughts
The medical examination for a green card might feel a bit overwhelming at first, but once you know what to expect, it will become a straightforward process. Just remember, Form I-693 isn’t just any form—it plays a key role in your immigration journey. If you adhere to the correct procedures, you can successfully fulfill your medical requirements and maintain the timeliness of your green card application.