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The green card medical exam (Form I-693)
How to do the immigration medical exam with a USCIS-designated doctor, what it costs, which vaccines you need, and what to do with the sealed envelope.
Rules as of November 2026. Before your visit, check the latest edition of Form I-693 at uscis.gov/i-693.
Start here
- If you apply for a green card from inside the US, Form I-693 from a civil surgeon (a USCIS-designated doctor) goes in with Form I-485, or the application may be rejected.
- Find a civil surgeon on the myUSCIS Find a Civil Surgeon page. Prices are not regulated: ask several offices and get a written estimate.
- Filing by mail: don't open the sealed envelope. Filing online: open it, upload the form and keep the original.
Form I-693 (Report of Immigration Medical Examination and Vaccination Record) goes with Form I-485 (the green card application from inside the US). Since December 2, 2024 they must be filed together, or USCIS may reject the I-485. An immigration lawyer can tell you whether this applies to you.
Check whether you need the full exam
Only part of Form I-693, with the vaccination record, is filed by refugees (Forms I-590 or I-730) and family members of asylees (derivative asylees, Form I-730) who already had an exam abroad with a State Department panel physician; family members must have applied for a green card within a year of becoming eligible. If the vaccination record was not filled in correctly abroad, only part of the form is also filed by K-1, K-2, K-3 and K-4 visa holders (the fiancé(e) or spouse of a US citizen and their children) who had the exam abroad no more than a year before applying, and by Afghans who came under Operation Allies Welcome and had the exam abroad. Everyone else needs a full exam. The instructions at uscis.gov/i-693 say which parts to file.
Find a doctor designated by USCIS
The exam is done in the US by a civil surgeon, a doctor USCIS designated for these exams. Find one on the myUSCIS Find a Civil Surgeon page.
Compare prices at several offices
USCIS does not regulate prices, and they vary. Many civil surgeons don't take insurance, and insurance may not cover much of the exam. Ask the price ahead and get a written estimate (Good Faith Estimate).
Prepare the form and documents
Print the latest edition of Form I-693 and fill in Part 1, but don't sign until the doctor tells you to. Bring your medical records, including your vaccination record, and a government-issued ID: the doctor must check who you are.
Go to the exam in person
The exam can't be done by video. CDC (the federal disease control agency) technical instructions set what it includes: for example, gonorrhea and syphilis tests for some ages, and a chest X-ray may be needed for the tuberculosis part. The doctor signs the form only after the whole exam.
Receive the sealed envelope
The doctor fills in, signs and seals the form in an envelope. If you file the I-485 by mail, don't open it: USCIS won't accept the form unsealed or damaged. If you file online, open the envelope and upload the form, and keep the original and envelope until the final decision: they may be asked for at the interview.
Remember how long the form is valid
A correctly completed Form I-693 signed by the doctor on or after November 1, 2023 stays valid while the application it was filed with is pending. If that application is withdrawn or denied, a new one needs a new form.
Vaccination rules for the exam
| What it means for you | |
|---|---|
| Which vaccines are required | Measles, mumps, rubella, polio, tetanus and diphtheria, pertussis, Hib (Haemophilus influenzae type B), hepatitis B and other vaccines recommended by the ACIP advisory committee, only those right for your age. |
| You are already vaccinated | Bring your vaccination records or proof of immunity: confirmed vaccines don't need to be repeated. |
| Some vaccines are missing | The civil surgeon can give them. You can also get them from your own doctor, then return to the civil surgeon with proof: only they fill in the form. |
| A series of several doses | One dose of each vaccine at the visit is enough; the rest can be done later with your own doctor. |
| Flu vaccine | Required if your exam is between September 1 and March 31 and the vaccine is available to your doctor. |
| COVID-19 vaccine | Not required since January 20, 2025. |
| Polio | Since May 1, 2024, everyone 2 months and older not vaccinated per ACIP gets one dose of IPV (inactivated vaccine), including adults with no record of childhood doses. |
| Who pays | You pay for all vaccines: ask the price before the visit. |
| Refusal on grounds of belief | An exemption is possible only if you object to all vaccines out of sincere religious or moral beliefs; Forms I-602 and I-601 are for this. |
Fort Greene Health Center Immunization Clinic
Any statusPrice depends on income
A City vaccine clinic for ages 4 and up. Vaccines include Td/Tdap (tetanus, diphtheria, pertussis) and MMR (measles, mumps, rubella). Sliding-scale fees, no money taken on site. Bring your vaccination records. Walk-ins are seen if there is room. City agencies must give you a free interpreter.
Refusing vaccines on grounds of belief: waiver Forms I-602 and I-601
Any status
An exemption is possible only if you object to all vaccines out of sincere religious or moral beliefs. Refugees and asylees file Form I-602 (Application by Refugee for Waiver of Grounds of Excludability); people applying through an approved Form I-130 (relative petition) or I-140 (immigrant worker petition) file Form I-601 (Application for Waiver of Grounds of Inadmissibility).
The list is on its own page: "Doctors and clinics: our members' experience". QARAVAN has not checked licenses or the accuracy of these reviews.
- Civil surgeon
- A doctor whom USCIS has designated to perform the immigration medical exam for people applying inside the U.S.
- Panel physician
- A doctor abroad designated by the U.S. State Department who performs the exam before arrival.
- Form I-485
- Application to Register Permanent Residence or Adjust Status, the green card application filed inside the U.S.
- Form I-693
- Report of Immigration Medical Examination and Vaccination Record, the doctor's report on the exam and vaccinations.
- Good Faith Estimate
- A written cost estimate that you can request before the visit.
- Waiver
- Permission not to meet a requirement. For vaccines, only with a sincere religious or moral objection to all vaccines.
- ACIP
- The Advisory Committee on Immunization Practices, an advisory body to federal health agencies that recommends vaccines.
This is general information, not legal advice: QARAVAN has no lawyers. QARAVAN does not help anyone enter the US and cannot arrange visas, invitations, sponsorship or evacuation. For your own case, talk to a licensed immigration attorney or a representative accredited by the U.S. Department of Justice.
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