Green Card Exam? See a USCIS Civil Surgeon, File With I-485
If you are applying to adjust status (for a green card) inside the U.S., you need an immigration medical exam from a USCIS-designated doctor (civil surgeon), who gives you the completed, signed I-693 in a sealed envelope. USCIS says that since December 2, 2024, you must submit Form I-693 or a partial I-693 with your I-485, or USCIS may reject the I-485.
Form I-693 shows that an applicant is not inadmissible on health-related grounds. This article follows the USCIS I-693 page: how to find a doctor, what to do with the envelope, who submits only part of the form, and what to know about fees and editions. It only follows the USCIS page and doesn’t judge individual cases.
Finding a doctor and getting the form
USCIS explains (USCIS I-693):
- Find a designated doctor: the exam must be done by a USCIS-designated doctor; search with the USCIS Find a Civil Surgeon tool at my.uscis.gov/findadoctor.
- Sealed envelope: the doctor gives you the completed, signed form in a sealed envelope; don’t accept it if the envelope isn’t sealed.
- You submit it: you submit the form to USCIS yourself; the civil surgeon doesn’t.
- Vaccinations: the vaccination record is Part 10 of the form, and vaccination requirements are explained on a separate page.
How to submit
- File with the I-485: since December 2, 2024, you must submit Form I-693 or a partial I-693 with your I-485, or USCIS may reject the I-485.
- By mail: send the original sealed envelope with your I-485, to the address in USCIS’s I-485 filing address list.
- Online: some applicants can file the I-485 online; online filers open the envelope and upload the form themselves, and keep the original form and envelope until USCIS makes a final decision, since USCIS may ask to see them at an interview or ask you to submit them.
- If the lockbox rejects your package: if your package is returned for reasons such as an unpaid fee or a missing signature and the envelope was already opened, you may refile with the opened original form, any documents the civil surgeon included and a copy of the rejection notice.
Who submits only part of the form
A partial I-693 means Parts 1 to 5, Part 7 and Part 10 (the vaccination record).
- Always partial: refugees (Form I-590 or I-730) who already had an immigration medical exam by a panel physician outside the U.S., and derivative asylees (Form I-730) who had the exam abroad and applied within 1 year of becoming eligible.
- If the overseas vaccination record wasn’t completed: K-1, K-2, K-3 and K-4 nonimmigrants who had the exam abroad within 1 year before applying to adjust status, and Afghan nationals who arrived under Operation Allies Welcome and had the exam abroad.
- Class A conditions: if an overseas exam found a Class A condition, or there is reason to believe you acquired one after entry, you may need a new exam.
Fees and editions
- USCIS fee: the I-693 filing fee is on the USCIS fee schedule (G-1055); the I-693 page doesn’t state an amount.
- Doctor’s fee: each civil surgeon sets the exam fee, and fees may vary.
- Edition: the current edition is 01/20/25; if the doctor signs on or after July 3, 2025, only the 01/20/25 edition is accepted. Printed forms must have every page from the same edition with the edition date and page numbers visible; missing or mixed pages may lead to rejection.
- Signature: USCIS says it will reject any unsigned form.
For what to do after an adjustment of status is approved, see Green Card Approved, Get a New SSN Card and Show It at Work; for refugees applying for a green card after 1 year, see Refugees Apply for a Green Card After 1 Year, No I-485 Fee; for what to bring to a biometrics appointment, see Biometrics, Bring Notice and ID, Reschedule 12 Hours Ahead.
What this article doesn’t cover
- How long the exam is valid: the page doesn’t say and only points to the USCIS Policy Manual, which this article didn’t review.
- Fee amounts: the USCIS fee is on the fee schedule and doctors’ fees vary; this article didn’t look up either.
- Which vaccines: vaccination requirements are on another page that this article didn’t review.
- Your own case: this article doesn’t judge whether you need the exam or whether you submit the full or partial form.
FAQ
Can my own family doctor do the exam?
USCIS says the exam must be done by a USCIS-designated doctor (civil surgeon); you can search with the USCIS Find a Civil Surgeon tool.
Can I open the doctor’s envelope to look?
If you file by mail, submit the original sealed envelope. Only online filers open it to upload the form, and they must keep the original form and envelope until USCIS makes a final decision.
Can I wait and bring the I-693 to my interview?
USCIS says that since December 2, 2024, you must submit Form I-693 or a partial I-693 with your I-485, or USCIS may reject the I-485.
How much does the exam cost?
USCIS says each civil surgeon sets the exam fee and fees may vary; the USCIS I-693 filing fee is on the fee schedule (G-1055).
Sources and date checked
All checked on 2026-11-01.
- USCIS, I-693, Report of Immigration Medical Examination and Vaccination Record (page updated 2026-07-24):https://www.uscis.gov/i-693