The Form I-693 medical exam is one of the most nerve-wracking steps of adjustment of status, almost always because nobody explains it. It is not an exam you pass or fail: it is a public health report. This guide covers what they check, which vaccines USCIS requires, how long it takes and the mistakes that force people to come back.
What it is actually for
USCIS requires Form I-693 to rule out four specific things: communicable diseases of public health significance, missing required vaccines, physical or mental disorders with harmful behavior, and drug use. That is all. Having diabetes, high blood pressure or extra weight does not affect your case.
Whoever signs it must be a civil surgeon, a physician designated by USCIS inside the United States. We explain that role in depth in what a USCIS-authorized doctor is.
What happens on exam day
- History and vaccination review. Your previous doses are compared against what USCIS requires.
- Physical exam, with vital signs, a general check and questions about conditions and medications.
- Tuberculosis screening. Under the CDC technical instructions, applicants age 2 and older get a blood test (IGRA). A positive result leads to a chest X-ray, and that part adds several days.
- Other lab tests based on age and history, such as syphilis and gonorrhea.
- Missing vaccines, given on site.
- Completing and sealing the form, which we hand you in a closed envelope.
The visit usually takes under an hour, unless an X-ray or a second vaccine dose is needed.
The vaccines USCIS requires
The official list includes mumps, measles, rubella, polio, tetanus and diphtheria, pertussis, haemophilus influenzae type B, hepatitis A and B, varicella, pneumococcal disease, COVID-19 and seasonal influenza, among others. Not all apply at every age: the full, current list is on the CDC vaccination page for civil surgeons.
If you bring your vaccination card, it counts even if it is from Mexico, Central America or Venezuela and written in Spanish. Without it, the usual options are repeating doses or running blood tests to prove immunity, and both cost time and money.
The three mistakes that force a repeat
- Opening the sealed envelope. The most expensive mistake. If it arrives open, USCIS can reject it and the exam has to be done again.
- Seeing a doctor who is not a civil surgeon. Check the name in the official USCIS finder.
- Skipping the second dose. Some vaccines need a booster; ask on day one whether your schedule requires it.
When should you do it?
Since 2024 the signed form does not expire, per the update to the USCIS policy manual. The practical move is to do it once your case is filed, and keep the sealed envelope until it is requested.
Where to get it done in Pasadena
At Clínica Hispana Nueva Salud Michoacana we are a USCIS-authorized civil surgeon and we perform the full exam, with lab work and vaccines in the same place, all in Spanish. We are at 6500 Spencer Hwy Ste 180, open seven days a week. Call (832) 617-7439 or walk in and ask what to bring.