Instructions for Report of Medical Examination
and Vaccination Record
Department of Homeland Security
OMB No. 1615-0033
U.S. Citizenship and Immigration Services
What Is the Purpose of Form I-693?
Form I-693 is used to report results of a medical examination to U.S. Citizenship and Immigration Services (USCIS).
The examination is required to establish that applicants who are seeking immigration benefits are not inadmissible to
the United States on public health grounds. You can find a list of those health-related grounds in section 212(a)(1) of
the Immigration and Nationality Act (INA). The list is also available in these Instructions in Item Number 9. under the
section entitled Frequently Asked Questions.
The results of your medical examination are confidential and are used primarily for immigration purposes. When required
by law, the civil surgeon may share your results with public health authorities. USCIS will generally not discuss your
medical issues with other individuals, such as your attorney or BIA-accredited representative, immigration officers, or
other government officials, unless they have a need to know the information.
NOTE: If you are applying for adjustment of status as a refugee, a derivative of an asylee, or a K or V nonimmigrant
visa holder, before reading any further, see section entitled Frequently Asked Questions, Item Numbers 2. - 5., of these
How Do I File Form I-693?
A separate Form I-693 is required for each applicant. There is no filing fee for this form.
1. Carefully read all these instructions, including the section entitled Frequently Asked Questions.
2. Contact a doctor who is designated by USCIS as a civil surgeon to make an appointment.
3. Fill out Part 1. Information About You of Form I-693. Do not sign the form until the civil surgeon tells you to
sign it. You must sign in the presence of the civil surgeon.
4. Attend your medical examination appointment and all follow-up examinations, as required. If you have any medical
records, including vaccination records, take them with you to the initial appointment.
5. The civil surgeon is required to give you the completed Form I-693 in a sealed envelope for you to submit to
USCIS. Do not accept the form from the civil surgeon unless it is in a sealed envelope. USCIS will return your Form
I-693 to you if it is not in a sealed envelope or if the envelope is opened or altered in any way. The civil surgeon
should also give you a copy of the completed Form I-693 for your records.
6. Submit your completed Form I-693 in the sealed envelope to USCIS. Please see our website at
A. If you are applying for adjustment of status: Submit Form I-693 according to the instructions on Form I-485,
Application to Register for Permanent Residence or Adjust Status.
B. For all other applicants: Follow the application’s instructions, follow the instructions that the office requesting
the medical examination gave you, or call the USCIS National Customer Service Center at 1-800-375-5283 for
the most current information on where to file this benefit request. For TTY (deaf or hard of hearing) call:
Form I-693 Instructions 02/07/17 N
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