If you are applying for a green card from inside the United States, understanding the Form I-693 with Form I-485 requirement is essential.
U.S. Citizenship and Immigration Services (USCIS) now requires certain applicants to submit Form I-693, Report of Immigration Medical Examination and Vaccination Record, at the same time they file Form I-485, Application to Register Permanent Residence or Adjust Status.
Failing to include the required green card medical exam form may result in your application being rejected or delayed.
This updated I-485 medical requirement is designed to reduce processing delays, prevent Requests for Evidence (RFEs), and improve overall case efficiency.
According to USCIS policy guidance, most applicants adjusting status must prove they are not inadmissible under health-related grounds of immigration law.
Why USCIS Requires Form I-693 with Form I-485
USCIS updated its filing instructions so that many applicants must now submit both forms together.
The goal is simple: reduce delays caused by missing medical exams.
In the past, applicants often filed Form I-485 without the required adjustment of status medical exam. USCIS then had to issue RFEs, which slowed down case decisions and increased backlogs.
According to official USCIS data, the agency has processed millions of immigration benefit requests in recent fiscal years while working through historic backlogs. Filing policies that reduce RFEs help improve adjudication efficiency.
By requiring Form I-693 with Form I-485 upfront, USCIS can review cases more quickly and reduce unnecessary follow-up requests.
What Is Form I-693?
Form I-693 is the official Report of Immigration Medical Examination and Vaccination Record.
It confirms that you meet the health-related requirements for permanent residence.
The medical exam verifies that you:
Do not have communicable diseases of public health significance;
Have received required vaccinations; and
Do not have health conditions that would make you inadmissible.
Health-related inadmissibility grounds are defined under U.S. immigration law and outlined by USCIS policy guidance.
Only a USCIS-approved civil surgeon can complete this form for applicants adjusting status inside the U.S.
What Happens If You Don’t Submit Form I-693?
If you are required to file Form I-693 and you do not include it with your Form I-485, USCIS may reject your application.
A rejection means your entire package is returned, and you must refile. This can delay your green card timeline by several months.
Even if USCIS initially accepts your application, the agency may later issue an RFE requesting the medical exam. That additional step increases processing time and creates unnecessary stress.
Submitting the medical exam together with Form I-485 is the safest way to avoid delays.
Who Must Submit the Medical Exam with Form I-485?
Most applicants filing for adjustment of status must complete the I-485 medical requirement.
This includes employment-based applicants, family-based applicants, and many humanitarian categories.
However, immigration rules can vary depending on your specific category. Always review the latest Form I-485 instructions directly from USCIS before filing:
If you are unsure about your eligibility or requirements, consult a qualified immigration professional before submitting your application.
Updated USCIS Processing Environment
USCIS continues working to reduce case backlogs and modernize its processing systems.
In recent fiscal years, the agency has implemented efficiency measures aimed at reducing delays and improving adjudication timelines.
Requiring Form I-693 with Form I-485 is part of this broader effort. By minimizing RFEs, USCIS improves completion rates and reduces administrative strain.
HOW TO Submit Form I-693 with Form I-485 (Step-by-Step Guide)
If you are preparing your adjustment of status application, follow these steps carefully.
Step 1: Confirm You Need a Medical Exam
Review the official Form I-485 instructions to confirm you must submit Form I-693.
Most adjustment applicants are required to complete the exam.
Step 2: Find a USCIS-Designated Civil Surgeon
Use the official USCIS tool to locate a designated civil surgeon.
Do not use a regular doctor unless they are authorized by USCIS.
Step 3: Schedule and Complete the Medical Exam
Attend your appointment and bring vaccination records, passport, and government-issued ID.
The civil surgeon will conduct the required physical exam and administer necessary vaccines.
Step 4: Receive Sealed Form I-693
The civil surgeon will give you the completed Form I-693 in a sealed envelope.
Do not open the envelope. USCIS will reject it if it has been opened.
Step 5: Submit Form I-693 with Form I-485
Include the sealed Form I-693 package with your Form I-485 submission.
Follow all mailing instructions listed on the USCIS website.
Step 6: Keep Copies for Your Records
Make copies of everything before mailing your application.
Always use a trackable mailing service.
Frequently Asked Questions (FAQ)
Do I always have to submit Form I-693 with Form I-485?
In most adjustment of status cases, yes. USCIS updated its filing instructions to require the medical exam form to be submitted at the same time as Form I-485 to reduce RFEs and processing delays. Always check the latest instructions on the USCIS website before filing.
What happens if my Form I-693 is missing?
If you are required to submit Form I-693 and you do not include it, USCIS may reject your Form I-485. A rejection means your application will be returned, and you will need to refile, which can delay your green card process significantly.
How long is Form I-693 valid?
The validity of Form I-693 depends on USCIS policy at the time of filing. USCIS has updated validity rules in recent years, so it is important to check the current guidelinesbefore submitting your application.
Can any doctor complete Form I-693?
Only a USCIS-designated civil surgeon can complete Form I-693 for applicants adjusting status inside the United States. You must use the official USCIS civil surgeon locator tool to find an authorized physician.
Why did USCIS change this rule?
USCIS implemented this requirement to reduce the number of Requests for Evidence and speed up case processing. When applicants submit the medical exam at the same time as Form I-485, it allows officers to adjudicate cases more efficiently and reduce unnecessary delays.
Does this requirement apply to employment-based applicants?
Most employment-based adjustment applicants must also submit Form I-693 with Form I-485. The medical exam requirement applies broadly unless you qualify for a specific exemption under immigration law.
Final Thoughts
Submitting Form I-693 with Form I-485 is now a critical part of the adjustment of status process for most green card applicants. Filing both forms together helps prevent application rejections, reduces the risk of receiving a Request for Evidence (RFE), and keeps your case moving forward without unnecessary delays. Even a small filing mistake can add months to your immigration timeline.
USCIS implemented this requirement to improve efficiency and reduce backlogs, so applicants who follow the updated instructions place themselves in a stronger position. Before mailing your application, carefully review the latest Form I-485 and Form I-693 instructions directly on the official USCIS website to make sure you are meeting all current requirements. Staying informed and organized is one of the best ways to protect your path to permanent residence.
