If you are applying for a green card, you will be asked for Form I-693 at some point. The rules for this exam changed several times between 2023 and 2025, so here is how it works today, step by step, so you arrive at the clinic prepared.
What is Form I-693 and who can sign it?
It is the medical report USCIS uses to confirm you do not have a health condition that blocks your immigration case. Only a doctor designated by USCIS as a civil surgeon can sign it. A form signed by any other doctor, even a licensed one, is not accepted. At Clínica Hispana Mangum the exam is done by a designated civil surgeon, in Spanish or English.
What happens during the visit?
- Documents. We review your photo ID, vaccination records and any medical reports you bring.
- History and physical exam. Questions about past illnesses, medications, mental health and substance use, plus a general check of eyes, ears, heart, lungs, abdomen and skin.
- Tests. A tuberculosis blood test (IGRA) from age 2, a syphilis test for ages 18 to 44 and a gonorrhea test for ages 18 to 24. If the TB test is positive, a chest X-ray is needed before the form can be finished.
- Vaccines. Your records are reviewed and any missing vaccines are given.
- Form. Once all results are in, the civil surgeon completes Form I-693 and hands it to you in a sealed envelope.
Because some results take a few days, the form is usually not ready on the day of your first visit.
Which vaccines does USCIS require now?
It depends on your age and what is already documented. CDC instructions include measles, mumps and rubella (for people born in 1957 or later), tetanus and diphtheria (Td or Tdap), polio, hepatitis A and B, varicella, flu during flu season, and pneumococcal, meningococcal, rotavirus and Hib at the ages that apply.
The COVID-19 vaccine is no longer required. USCIS stopped requiring it in January 2025 and the CDC removed it from its instructions in March 2025. Bring written proof of any vaccine you already have; without a record it counts as not given.
How is the form submitted to USCIS?
- Since December 2, 2024, Form I-693 must be filed together with Form I-485. If you send it separately, USCIS may reject the application.
- Paper filing: send the envelope unopened with your package.
- Online filing: USCIS says to open the envelope and upload the scanned form.
- Since July 3, 2025, only the 01/20/25 edition of the form is accepted.
That is why it is best to schedule the exam when your attorney or representative has the package almost ready.
How long is it valid?
Since June 11, 2025, USCIS treats Form I-693 as valid for the application it is filed with, without a fixed expiration date. If your case has special circumstances, check with your attorney.
What should you bring?
- Passport or another photo ID.
- Vaccination records, even if they are in another language.
- Previous X-rays or medical results, if you have them.
- A list of the medications you take.
- Your A-Number, if you already have one.
What if something comes up?
Missing vaccines or a positive TB test do not end your case: the pending steps are completed before the form is signed. For some conditions there is a waiver your attorney handles; the civil surgeon does not give legal advice.
Get your exam at Clínica Hispana Mangum
See our I-693 immigration medical exam, vaccines and tuberculosis testing, or read what a civil surgeon is. We are at 2912 Mangum Rd, Suite A, open every day from 9 AM to 9 PM. Call (832) 834-5507 to confirm the cost before you come.
Sources: USCIS: Form I-693 · USCIS Policy Manual, Vol. 8, Part B · CDC: technical instructions for civil surgeons
