I-693, Report of Immigration Medical Examination and Vaccination Record
ALERT: Effective Jan. 22, 2025, USCIS waives any and all requirements that applicants for adjustment of status to that of a lawful permanent resident present documentation on their Form I-693, Report of Immigration Medical Examination and Vaccination Record, that they received the COVID-19 vaccination. USCIS will not issue any Request for Evidence (RFE) or Notice of Intent to Deny (NOID) related to proving a COVID-19 vaccination. USCIS will not deny any adjustment of status application based on the applicant’s failure to present documentation that they received the COVID-19 vaccination.
Additional guidance is available for civil surgeons in the Special Instructions section below.
ALERT: Effective Dec. 2, 2024, if you are required to submit Form I-693, or a partial Form I-693 (such as the Vaccination Record), you must submit it with your Form I-485. Otherwise, we may reject your Form I-485.
ALERT: Effective April 4, 2024, any Form I-693 that was properly completed and signed by a civil surgeon on or after Nov. 1, 2023, does not expire. You can use it indefinitely as evidence that you are not inadmissible on health-related grounds. For more information, see the Policy Alert.
Additionally, effective Nov. 13, 2024, immigration medical examinations are valid indefinitely for certain Afghan nationals who arrived in the United States during Operation Allies Welcome. For more information on how this policy applies, see the Policy Alert.
ALERT: Urgent Message for USCIS Designated Civil Surgeons:
The Centers for Disease Control and Prevention (CDC) recently updated the Tuberculosis Technical Instructions for Civil Surgeons. Civil Surgeons must now register for access to eMedical, an electronic health processing system. Using eMedical will help the CDC maintain public health security and transition to electronic submission of immigration medical examinations. Civil Surgeons should have received emailed instructions to register; it is important that you follow these instructions and register immediately. If you did not receive the emails with instructions from the CDC and eMedical, please email OPSCivilSurgeons@uscis.dhs.gov.
If you are applying for adjustment of status to become a lawful permanent resident, use this form to establish that you are not inadmissible to the United States on health-related grounds.
A list of the health related grounds of inadmissibility can be found in section 212(a)(1) of the Immigration and Nationality Act(INA). For more information on the validity of Form I-693, see the USCIS Policy Manual Volume 8, Part B, Chapter 4.
Form Details
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After completing your immigration medical examination, the civil surgeon must give you, the applicant, the completed Form I-693 in a sealed envelope. Do not accept it if it is not in a sealed envelope. We will return the form to you if it is not in a sealed envelope, or if the envelope has been opened or altered.
You (the applicant, not the civil surgeon) must submit your Form I-693 to USCIS. If you are applying for adjustment of status, you must submit Form I-693 by mail with your Form I-485, to the location specified for your Form I-485 (see the Direct Filing Addresses for Form I-485). Otherwise, your Form I-485 may be rejected. .
Other applicants: Follow the instructions on or included with the application, or the instructions given to you by the office requesting the immigration medical examination.
If you are filing Form I-485, and if you are required to submit a Form I-693 or partial Form I-693 (such as the Vaccination Record), you must submit it with your Form I-485. Otherwise, your Form I-485 may be rejected. For more information about Form I-693 requirements, visit www.uscis.gov/i-693
You can find the filing fee for Form I-693 by visiting our Fee Schedule page.
Fees for immigration medical examinations are established by the civil surgeon. Fees may vary by physician.
Filing Tips: Review our Tips for Filing Forms by Mail page for information on how to ensure we will accept your form.
Don’t forget to sign your form. We will reject any unsigned form.
Guidance for Civil Surgeons Related to the COVID-19 Vaccine
As of Jan. 22, 2025, USCIS has waived any and all requirements that applicants for adjustment of status to that of a lawful permanent resident present documentation on their Form I-693 that they received the COVID-19 vaccination. USCIS will not issue any Request for Evidence or Notice of Intent to Deny related to proving a COVID-19 vaccination. USCIS will not deny any adjustment of status application based on the applicant’s failure to present documentation that they received the COVID-19 vaccination.
As a civil surgeon, you should continue to follow the form instructions and Technical Instructions for Civil Surgeons. Please see the following instructions for clarification on how to fill out the Vaccination Record on Form I-693 for applicants who decline to receive or present documentation of having received the COVID-19 vaccination.
As of Jan. 22, 2025, if the applicant is only missing documentation of having received the COVID-19 vaccination, you should:
- Indicate in the results portion of Part 10, Vaccination Record, of Form I-693, “Applicant does not meet immunization requirements”; and
- Write in the remarks section of Part 10, “Applicant refuses COVID-19 vaccination, but meets all other vaccination requirements.”
If the applicant is missing documentation of having received any required vaccinations other than the COVID-19 vaccination, you should:
- Indicate in the results portion of Part 10, “Applicant does not meet immunization requirements,” or “Applicant will request an individual waiver based on religious or moral convictions” as appropriate; and
- In the remarks section of Part 10, indicate if the applicant is missing all vaccines or list the missing vaccine(s).
NOTE: Applicants are not required to provide you with evidence that they obtained a waiver of the vaccination requirements for you to conduct the immigration medical examination or complete any portion of Form I-693. An applicant’s refusal to receive or present documentation of having received any of the required vaccines may affect the applicant’s eligibility for the immigration benefit sought, but does not change the requirement that you follow the Form I-693 instructions and the Technical Instructions for Civil Surgeons and does not prevent you from providing the applicant with a completed and signed Form I-693.
- Immigration Medical Examinations
- USCIS Policy Manual Guidance on Review of Medical Examination Documentation
Civil Surgeons
Vaccination
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