Navigating the I-693 USCIS Form: A Comprehensive Guide

The process of becoming a lawful permanent resident in the United States can be complicated and difficult. One of the many steps and forms required is the completion of Form I-693, the Report of Medical Examination and Vaccination Record. This form ensures that applicants meet the United States Citizenship and Immigration Services (USCIS) health and vaccination requirements. In this article, we will go over Form I-693 in detail, including its purpose, how to complete it, and the role it plays in the green card application process. Understanding the complexities of this important form will better equip you to navigate your path to permanent residency in the United States.

The Purpose of Form I-693: Protecting Public Health and Ensuring Admissibility

The Report of Medical Examination and Vaccination Record, Form I-693, is a vital part of the U.S. immigration process, particularly for those seeking adjustment of status to permanent residency. This form addresses two primary concerns: protecting public health and determining the admissibility of applicants to the United States.

Protecting Public Health:

The United States places a strong emphasis on safeguarding the health and well-being of its citizens. One method to ensure this is by preventing the entry of immigrants with communicable diseases that could pose a risk to public health. Form I-693 helps identify such health conditions through a thorough medical examination, enabling authorities to manage and mitigate potential health risks.

Applicants for permanent residency must be screened for various communicable diseases, including tuberculosis, syphilis, and gonorrhea, in accordance with the Centers for Disease Control and Prevention (CDC) guidelines. The results of these tests, along with vaccination records, contribute to maintaining public health safety.

Ensuring Admissibility:

In addition to protecting public health, Form I-693 plays a crucial role in determining whether an applicant is admissible to the United States under health-related grounds. Certain medical conditions may make an individual inadmissible under U.S. immigration law, including:

• Communicable diseases of public health significance (e.g., tuberculosis, syphilis, and gonorrhea).

• Physical or mental disorders with associated harmful behavior that could pose a threat to the property, safety, or welfare of the applicant or others.

• Drug abuse or addiction, including dependence on substances regulated under the Controlled Substances Act.

By completing Form I-693 and undergoing the medical examination, applicants demonstrate that they do not have any conditions that would make them inadmissible. Additionally, this examination ensures that applicants meet the CDC’s required vaccination standards, further contributing to public health protection.

Who Needs to Complete Form I-693: Understanding the Eligibility Criteria

Individuals seeking adjustment of status to become a lawful permanent resident (green card holder) in the United States must submit Form I-693, the Report of Medical Examination and Vaccination Record. Understanding whether this form is required is critical to determining your eligibility and ensuring your application is processed correctly.

Generally, applicants in the following categories are required to complete Form I-693:

• Individuals applying for adjustment of status to obtain a green card under various categories (such as family-based, employment-based, or other special immigrant categories) must submit Form I-693 as part of their application process.

• Refugees applying for adjustment of status: Refugees who have been in the United States for at least one year and are now applying to adjust their status to become lawful permanent residents must complete the vaccination portion of Form I-693. A full medical examination may not be required if they had a complete examination before arriving, unless a Class A medical condition was previously identified.

• K nonimmigrant visa holders (fiancé(e) or spouse of a U.S. citizen): K-1, K-2, K-3, or K-4 nonimmigrant visa holders adjusting status to permanent residency must submit Form I-693 if the medical examination conducted abroad is more than one year old or did not include all required vaccinations.

• V nonimmigrant visa holders (spouse or child of a lawful permanent resident): V visa holders applying for adjustment of status must also submit Form I-693, with the same vaccination and medical requirements as other visa holders.

• Other nonimmigrant categories: Some nonimmigrant visa holders may be required to submit Form I-693 if USCIS specifically requests it. This can apply in cases where there is a change of status or an extension of stay and medical records are necessary to assess eligibility.

It is important to note that applicants who are already lawful permanent residents and are applying to remove conditions on their residency (such as Form I-751 for marriage-based green cards or Form I-829 for entrepreneur green cards) generally do not need to submit Form I-693.

Finally, understanding the eligibility criteria for Form I-693 ensures that you submit the correct documentation for your green card or immigration application. Most applicants for adjustment of status, particularly those seeking permanent residency, must meet the medical and vaccination requirements set by U.S. Citizenship and Immigration Services (USCIS)​.

Finding a Designated Civil Surgeon: The Key to a Valid I-693 Form

It is essential to have your medical examination performed by a designated civil surgeon authorized by U.S. Citizenship and Immigration Services (USCIS) when completing Form I-693. The designated civil surgeon’s role is to conduct the medical examination and ensure that you meet the necessary health and vaccination standards for permanent residency in the United States.

Follow these steps to locate a designated civil surgeon in your area:

- 1. Go to the USCIS website: Navigate to the official USCIS website and use the “Find a Doctor” tool, which helps applicants locate authorized civil surgeons.

- 2. Enter your address: In the search bar, enter your ZIP code, city, or state, and then click “Search” to generate a list of designated civil surgeons near you.

- 3. Examine the following items: The generated list will include the names, addresses, and phone numbers of the designated civil surgeons in your area. Take the time to review the list and choose the doctor that best meets your needs.

- 4. Schedule an appointment: Contact the civil surgeon’s office of your choice to schedule your medical examination. Keep in mind that appointment availability varies, so it’s important to plan ahead to avoid delays in your application process.

- 5. Inquire about costs: The cost of the medical examination can vary depending on the civil surgeon’s practice and any additional tests or vaccinations required. To avoid surprises, inquire about the fees when scheduling your appointment.

Decoding the Medical Examination: What to Expect During Your Appointment

A crucial step in the green card application process is the medical examination for Form I-693, the Report of Medical Examination and Vaccination Record. Here's an overview of what to expect during your appointment with a designated civil surgeon to help you prepare.

1. Bring the necessary documents to your appointment, including a government-issued photo ID (such as a passport or driver’s license), vaccination records, and an unsigned copy of Form I-693. If you have any pre-existing medical conditions, bring any relevant medical records with you. If any documents are in a language other than English, it’s essential to obtain certified translation services before your appointment. Accurately translated documents will help ensure a smooth and efficient examination, allowing the civil surgeon to assess your medical history and vaccination records effectively.

Do you have inquiries regarding certified translations? We invite you to review our informative article, where we address various questions related to certified translations.

2. Physical examination: The designated civil surgeon will conduct a general physical examination, including checking your height, weight, blood pressure, and other vital signs, as well as reviewing your medical history.

3. Mental health evaluation: The civil surgeon will assess your mental health by asking questions related to your medical history and any mental health conditions that could affect your admissibility.

4. Tuberculosis (TB) screening: Applicants aged two and older will undergo tuberculosis screening, which may include a skin test or a blood test (IGRA). If the initial test is positive or if you have a history of tuberculosis, a chest X-ray may be required to rule out active infection.

5. Syphilis blood test: Applicants aged 15 and older will be tested for syphilis. If you test positive, you may need to complete treatment before your application can proceed.

6. Vaccination evaluation: The civil surgeon will review your vaccination records and administer any missing vaccines required by the Centers for Disease Control and Prevention (CDC) for immigration purposes.

7. Completion of Form I-693: After the examination, the designated civil surgeon will complete, sign, and seal Form I-693 in an envelope. This sealed envelope must be submitted to USCIS along with your adjustment of status application (Form I-485) or brought to your interview.

By understanding what to expect during your medical examination, you can be better prepared and feel more at ease throughout the Form I-693 process. Ensure a smooth medical examination by bringing all necessary documents, asking questions when needed, and following the guidance provided by the designated civil surgeon.

Mandatory Vaccinations: A Comprehensive List of Required Immunizations

Applicants must meet the vaccination requirements set by the Centers for Disease Control and Prevention as part of the medical examination for Form I-693, the Report of Medical Examination and Vaccination Record. The designated civil surgeon will review your vaccination records and, if necessary, administer any missing vaccines. The following is a comprehensive list of immunizations required for green card applicants:

- Measles, Mumps, and Rubella (MMR): Two doses are typically required, with the first administered on or after the first birthday and the second dose at least 28 days later.

- Polio: The inactivated polio vaccine (IPV) or the oral polio vaccine (OPV) is required depending on the applicant's age and vaccination history.

- Tetanus and Diphtheria Toxoids (Td or Tdap): Applicants must have completed a primary series of tetanus and diphtheria toxoids, with a booster dose received within the last ten years.

- Pertussis: For applicants who have never received the pertussis vaccine (commonly part of Tdap), a single dose is required.

- Hib: This vaccine is required for children under the age of five, with the number of doses determined by the age at which the vaccination series began.

- Hepatitis B: All applicants must receive the Hepatitis B vaccine, with the number of doses determined by the age at which the vaccination series began.

- Rotavirus vaccination: Required for infants aged 6 to 32 weeks.

- Meningococcal disease: Applicants aged 2 months to 55 years must have the meningococcal vaccine, with specific recommendations based on age and risk factors.

- Varicella (chickenpox): All applicants who do not have evidence of immunity from a previous infection or vaccination must receive the varicella vaccine.

- Pneumococcal disease: The pneumococcal vaccine is required for children under two years of age and adults 65 years and older, with recommendations based on age and risk factors.

- Seasonal influenza vaccine: During flu season (typically October through March), all applicants aged six months and older must receive the flu vaccine.

These vaccination requirements are subject to change, with specific recommendations based on the applicant’s age and risk factors. Always consult the CDC website for the most up-to-date information, and during your medical examination, follow the guidance provided by the designated civil surgeon.

I-693 Validity and Submission Timeline

When applying for an adjustment of status to become a lawful permanent resident in the United States, the validity of Form I-693 is critical. Maintaining the validity of your Form I-693 throughout the application process can help you avoid delays and the need for a new medical examination. Here's what you need to know about Form I-693’s validity and submission timeline:

How long is Form I-693 valid?

Form I-693 is generally valid for two years from the date of the civil surgeon’s signature. However, to remain valid throughout the application process, it must be submitted to USCIS within 60 days of the civil surgeon’s signature.

Scheduling your medical examination: It is crucial to schedule your medical examination at an appropriate time to ensure that your Form I-693 remains valid. Ideally, you should schedule the examination close to when you plan to submit your adjustment of status application (Form I-485) or around the time you expect to be interviewed.

Form I-693 submission: Form I-693 can be submitted with your initial adjustment of status application or later, if USCIS issues a Request for Evidence (RFE) or instructs you to bring it to your interview. Keep in mind the two-year validity period and the 60-day submission window from the date of the civil surgeon’s signature.

Understanding the validity of Form I-693 allows you to better plan your medical examination and ensure that the form remains valid throughout the green card application process. Always stay updated on changes in USCIS policies by consulting the official USCIS website for the most up-to-date information. If you have concerns or need specific guidance, it is advisable to consult an experienced immigration attorney for personalized assistance and to help you navigate the complexities of the application process.

The Cost of the Medical Examination: Planning for Expenses

The required medical examination for Form I-693 is a key step in the green card application process. It’s important to budget for the examination costs, which can vary depending on the designated civil surgeon’s practice, your location, and any additional tests or vaccinations required. Here are some suggestions for budgeting for medical examination expenses:

Understand the costs: The cost of the medical examination typically includes the examination itself, laboratory tests (such as blood tests and tuberculosis screening), and any required vaccinations. Additional charges may apply if extra tests or treatments are needed due to a specific medical condition, or if vaccinations are incomplete.

Compare civil surgeons: Since designated civil surgeons set their own fees, costs can vary from one practice to another. Contacting several civil surgeons in your area to ask about their fees will help you make an informed decision based on both cost and availability.

Consider additional tests or vaccinations: If your vaccination record is incomplete or if you require specific tests due to your medical history, the total cost of the medical exam may increase. To get an accurate estimate, discuss your situation with the civil surgeon’s office when scheduling your appointment.

Payment strategy: Be prepared to pay for the medical exam at the time of your appointment, as most civil surgeons require payment upfront. Payment methods may vary, so it’s important to inquire about accepted payment options when scheduling your exam.

Consider the following: Some health insurance plans may cover part of the costs related to medical exams and vaccinations. Check with your insurance provider to see if any of these expenses are covered under your policy.

By understanding the potential costs and planning accordingly, you can avoid unexpected expenses and ensure a smoother green card application process. Be sure to research and compare civil surgeons, know the likely costs, and plan for any additional tests or vaccinations that may be required based on your personal medical history.

Navigating Vaccination Waivers: When and How to Request an Exemption

In some cases, green card applicants may be unable to meet the vaccination requirements established by the Centers for Disease Control and Prevention (CDC) for Form I-693. Applicants may request a vaccination waiver under certain circumstances. Here's a rundown of when and how to apply for an exemption:

1. Waiver eligibility: Vaccination waivers may be granted under specific conditions, including:

a. Medical contraindications: If a vaccine is medically contraindicated for you (i.e., it would endanger your health), you may be granted a waiver. The designated civil surgeon must make this determination based on your medical history and examination.

b. Religious or moral convictions: You may request a waiver if you object to vaccinations because of sincerely held religious or moral beliefs. You must provide a detailed explanation of your objection and demonstrate that your beliefs are genuine and consistent with your overall lifestyle.

c. Vaccine unavailability: A waiver may be granted if a required vaccine is temporarily or permanently unavailable in your area or is not age-appropriate.

2. How to Apply for a Waiver:

a. Medical exemption: If the designated civil surgeon determines that a vaccine is medically contraindicated, Form I-693 will be annotated accordingly. USCIS will take this information into account when reviewing your application.

b. Religious or moral convictions waiver: To request a waiver based on religious or moral convictions, submit Form I-601, Application for Waiver of Grounds of Inadmissibility, along with a detailed explanation of your beliefs and supporting documentation. USCIS will review your request and determine whether it qualifies for an exemption.

c. Vaccine unavailability waiver: If a required vaccine is unavailable, the designated civil surgeon will annotate Form I-693 to reflect this. USCIS will consider this information when reviewing your application.

Please keep in mind that approval of a vaccination waiver is not guaranteed and is at the sole discretion of USCIS. Furthermore, a waiver may be conditional, requiring you to receive the vaccination at a later date if your circumstances change.

You can navigate the exemption process more effectively and ensure compliance with Form I-693 requirements by understanding the eligibility criteria and process for requesting a vaccination waiver. Always check the official USCIS website for the most up-to-date information and, if necessary, seek the advice of a qualified immigration attorney.

Can I Send I-693 Without RFE?

Yes, Form I-693 can be submitted with your initial adjustment of status application (Form I-485) or later, such as in response to a Request for Evidence (RFE) or at an interview. The instructions do not require waiting for an RFE before submitting Form I-693, but they do mention the option to submit it with the initial application to avoid delays.

So, you can send Form I-693 without an RFE, but you should ensure it's submitted at an appropriate time during your adjustment of status process to avoid any processing issues​.

What Happens After I-693 Deficiency Notice?

According to the instructions for Form I-693, after you receive an I-693 Deficiency Notice from USCIS, it serves as a reminder that you did not submit the completed Form I-693 with your adjustment of status application. This notice is not a rejection or denial of your application. USCIS will ask you to submit Form I-693 at a later stage, typically at your interview, or if the interview is waived, they will provide further instructions on when and how to submit it.

Here is a summary of the process:

• Do not submit Form I-693 immediately after receiving the deficiency notice.

• Wait for further instructions from USCIS, which may involve bringing the completed form to your interview or submitting it as part of a Request for Evidence (RFE) if the interview is waived.

“We collected and distilled information on immigration for our site visitors from USCIS and other sources as a basic guide. MotaWord is a translation platform providing certified translations for immigration applicants and not a law firm. The information provided should not be construed as legal advice and might not be current. For current information please refer to the USCIS website or speak to your licensed immigration attorney.”