Form I-693 Medical Exam: Civil Surgeon Guide for 2026
Everything you need to know about the USCIS medical exam (Form I-693): how to find a Civil Surgeon, what vaccines are required, what the visit costs, and how the new no-expiration rule affects your packet.
📋 Informational · Not legal advice
This article describes USCIS public requirements. MBO Immigration LLC prepares I-485 packets and helps clients schedule the medical exam, but is not a law firm or a medical practice.
Almost every adjustment of status (I-485) packet must include a sealed Form I-693, Report of Medical Examination and Vaccination Record. It documents that you don’t have any health-based grounds of inadmissibility and meet vaccination requirements.
Here’s what to know in 2026.
What does the I-693 cover?
A Civil Surgeon (a doctor designated by USCIS) checks for:
- Communicable diseases of public-health significance (TB, syphilis, gonorrhea, leprosy in active stage).
- Required vaccinations (varies by age and individual history).
- Mental disorders or substance abuse with associated harmful behavior.
- Other public-health-relevant conditions USCIS has flagged.
The doctor signs and seals the form, and you submit it sealed inside your packet.
Who can perform it?
USCIS only accepts the I-693 from a designated Civil Surgeon — not your regular family doctor unless that doctor is also designated.
Find one near you on the Find a Civil Surgeon tool.
What to bring to the appointment
- Government photo ID.
- Vaccination records you have (the more proof, the fewer shots required at the visit).
- Records of any mental health, substance abuse, or chronic condition treatment.
- Eye glasses if you wear them.
- Payment for the exam.
Vaccinations USCIS requires (2026)
The exact list updates with CDC recommendations. As of 2026, the required vaccines for green card applicants typically include:
- MMR (measles, mumps, rubella)
- Tdap (tetanus, diphtheria, pertussis)
- Polio
- Varicella (chickenpox)
- Influenza (seasonally)
- Hepatitis A
- Hepatitis B
- Pneumococcal (age-dependent)
- Meningococcal (age-dependent)
- Rotavirus (infants only)
- HPV (specific age range only)
You can satisfy each line by:
- Showing proof of past vaccination,
- Lab evidence of immunity (titer tests),
- Receiving the vaccine at the exam, or
- Medical exemption signed by the Civil Surgeon for a documented contraindication.
Cost
Civil Surgeons set their own fees. In 2026, exams typically cost $200–$500 with vaccines being extra ($20–$200 each). Bring a credit card or cash.
How long is the I-693 valid?
USCIS announced in November 2024 that a properly completed I-693 has no expiration date for purposes of adjudication, as long as it was properly signed and dated by the Civil Surgeon. This was a major policy change — older guidance said it expired after 2 years.
In practice, this means you can:
- File your I-485 with an I-693 you already have.
- Submit the I-693 later if USCIS issues an RFE.
- Avoid re-doing the exam every couple of years for cases stuck in long backlogs.
Always confirm the current rule on USCIS Form I-693 page before filing.
Common mistakes
- Opening the sealed envelope — USCIS rejects opened forms. Even if curious, leave it sealed.
- Picking a doctor who is not a Civil Surgeon.
- Missing vaccines the doctor didn’t catch — request the full vaccine line review.
- Not bringing prior records, leading to repeat shots and higher cost.
- Filing without I-693 entirely — USCIS now allows this in some cases (you can submit at the interview), but it’s safest to include it.
How MBO Immigration helps
For our clients we:
- Help you locate a Civil Surgeon near your address.
- Provide a list of records to bring, in your language.
- Coordinate the timing so the I-693 lines up with your I-485 packet.
- Re-organize the sealed envelope into your packet so it stays sealed.