Form I-693 requirements, and the checklist that prevents delays

What Form I-693 actually is

Form I-693 is the Report of Immigration Medical Examination and Vaccination Record. It is the medical report USCIS requires from most green card applicants, and only a USCIS-designated civil surgeon may perform the examination and sign it.

Bring the right edition

Editions matter more than people expect. Bring the 01/20/2025 edition. Since 3 July 2025, USCIS has accepted only that edition. Download it fresh from uscis.gov rather than reusing an old printout you saved months ago. An outdated edition means the form has to be completed again.

Fill in Part 1 yourself before your appointment. Everything after that belongs to the civil surgeon.

The eight things to bring

1. Government-issued photo ID: passport, driver’s license or state ID.
2. Form I-693, edition 01/20/2025: printed, with Part 1 completed by you.
3. All vaccination records: including records from your home country, however old.
4. Your USCIS receipt notice or A-number, if one has been issued to you.
5. A list of current medications, and any relevant medical or surgical history.
6. Prior TB testing or treatment records: including any past chest X-ray reports.
7. An interpreter, if you would be more comfortable with one.
8. A payment method: immigration exams are typically self-pay.

What the civil surgeon completes

After the physical examination and history review, the civil surgeon orders the required laboratory work, identifies which vaccinations are outstanding for your age, and writes the prescriptions so you can complete them at your pharmacy. Once results are back, they complete and sign the form.

The sealing rules

The completed form is sealed in an envelope, signed and stamped exactly the way USCIS requires. USCIS will reject a Form I-693 that arrives in an opened or tampered envelope. You are handed a separate unsealed copy for your own records, so there is never a reason to break the seal to check what it says.

What actually causes delays

In practice, three things:

• An outdated form edition, which has to be redone.
• Missing vaccination records, which either means new doses or blood titers to document existing immunity. Both are workable. See our guide to USCIS vaccination requirements.
• A positive TB screen, which requires a chest X-ray and further evaluation before the form can be completed. It is not a disqualification. See the TB blood test explained.

None of these stop your application. They change the timeline, which is why arriving prepared is worth the effort.