Changes to U.S. immigration status and applications for citizenship are incredibly complex. With an administration unfriendly to the prospect of immigration, it is important to be familiar with the basics of the application process. For those in the thick of it, and for medical providers advocating on their behalf, it is important to complete the I-693 in a timely manner, and to avoid common mistakes along the way.
Here are some FAQs to get acquainted with the process.
#1 - What is this form, and why is it necessary?
Form I-693 is essentially a health report card for an immigration application. Most green card applicants need to complete this form to be apply to adjust their status from within the U.S. Common scenarios where Form I-693 is required include green card applicants via family or employment sponsorship, refugees who have been in the U.S. for one year who wish to adjust their status, and K Visa (fiancé(e) of a U.S. citizen) holders or V Visa (spouse or child of a green card holder) holders. It is completed by a civil surgeon – a physician authorized through the United States Citizenship and Immigration Services (USCIS, an agency of the US Department of Homeland Security).
#2 - What does the medical exam entail?
The exam includes a thorough review of an individual’s medical and psychiatric history, physical examination, and review of vaccination history. Tuberculosis screening and sexually transmitted disease testing are often required. The physician will then seal the I-693 in an envelope and provide them to the immigrant applicant for submission to USCIS with their green card application. As of November 2023, the medical exam never expires.
"In consultation with the Centers for Disease Control and Prevention [...], USCIS has determined that a Form I-693’s evidentiary value should no longer be limited to a certain period if it is properly completed and was signed by a civil surgeon on or after Nov. 1, 2023." - USCIS Newsroom
#3 - How much does the exam cost, and where can you get it done?
The cost of the examination varies by location, but generally ranges from $200 to $500, whereas the associated lab tests ($150-$300) and vaccinations ($50-$200 per vaccination) will incur additional expenses. Sometimes you can find student-run clinics associated with medical schools that perform these services for free: check out this clinic in California offering free I-693 examinations.
You can find a civil surgeon here.
#4 - What are some common mistakes to avoid?
Outdated Forms: Make sure you use the most current version of the I-693.
Use of Correction Tape: USCIS may reject the form altogether if white-out is used on the form. Make sure to redo the form if any mistakes are made.
Submitting Unsealed Forms: Make sure to submit the I-693 in a sealed envelope as instructed.
Incorrect Vaccination Records: Simple dating mistakes on the vaccination records can result in unnecessary rejections.
Missing Pages: All required pages – including additional information pages – need to be included in the sealed envelope. Missing pages can cause significant delays or rejection.
#5 - How can I become a civil surgeon?
You can apply to become a USCIS-designated civil surgeon here. Only physicians with four or more years of practice after postgraduate training (internships and residencies not included) can apply. You can find the application form and instructions via the USCIS website.
More docs with civil surgeon status increases access for immigrants pursuing adjustments in their status. Get certified, avoid common mistakes, and encourage your colleagues to get involved in immigrant advocacy!
