Form I-693 (medical exam): what it is

Which exam you need. The fork decides everything else. Adjustment of status inside the US - Form I-693 with a civil surgeon from the USCIS list; the result is handed to you and you file it with the I-485. The consular path abroad - Forms DS-3025 / DS-3026 with the consulate panel physician (in some countries organized by IOM); the doctor usually sends the result to the consulate, and its validity is limited and affects the visa validity.

When to take it and how long it lasts. Since December 2, 2024 the I-693 is filed together with the I-485 - USCIS may reject a packet without it, so the old advice "they will send a request, you will mail it later" no longer works. Since June 11, 2025 the form stays valid while the application is pending; if the application is denied or withdrawn, the form expires and a new filing needs a new exam. Do not take the exam "just in case" long before filing, but do start on vaccinations early.

Where to find the doctor and what it costs. Only through the official USCIS search (find a civil surgeon) - a regular doctor or an insurance clinic will not do. There is no single price: the clinic and the number of missing vaccines set it; by community observations a civil surgeon exam cost about 300-400 dollars plus about 100 dollars per missing vaccine without insurance. Call several doctors from the list; check the form fee itself in the USCIS fee calculator.

Vaccines and the procedure. Bring every vaccination record you have, especially childhood ones: the doctor fills the vaccination worksheet from them, and missing shots are usually given on the spot; the practical chat advice is to test for antibodies first - for many positions titers are accepted instead of revaccination. The requirements apply to every family applicant by age. The exam takes two to three and a half hours, lab results come within about a week, and the full cycle with vaccines takes one to two weeks.

The envelope and typical mistakes. Do not accept the form without a sealed envelope or in an opened one - USCIS will not accept it; ask for two envelopes at once (in case the first is lost) and a copy for yourself, and confirm the doctor is completing the current edition of the form. Chronic diagnoses (diabetes, hypertension, depression without dangerous behavior) are Class B and do not lead to a denial by themselves; Class A is a narrow category such as active tuberculosis or missing mandatory vaccines.

How it relates to EB-1A and NIW. The I-693 is needed only at the green-card stage: after the I-140 petition is approved (or together with it under concurrent filing), when you file the I-485 inside the US. If you get the immigrant visa through a consulate, the consular scenario with a panel physician applies instead.