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Form I-693: Medical Examination and Vaccination Records Explained

Why it's needed?

Form I-693

Becoming a permanent resident of the United States can be an exciting time, but it also involves a lot of paperwork. USCIS will request a lot of documents and forms to prove your eligibility for a green card in the United States. 

One of these forms is Form I-693, Report of Medical Examination and Vaccination Record. This form helps USCIS decide if your presence in the United States could pose a risk to public health. 

Most people won’t have anything to worry about if they’ve received all of their necessary vaccinations and treated any curable communicable illnesses they’ve had throughout their lives. Here’s what you need to know about Form I-693.

What Is Form I-693?

Form I-693 deals with public health. Before you’re allowed to become a permanent resident, USCIS needs to know that your presence in America won’t pose any danger to public health. If you have or could spread serious communicable diseases, USCIS won’t allow you to immigrate into the country. 

This doesn’t mean that anyone who has ever been sick isn’t allowed into the country. If you’re a cancer survivor or if you’ve fully recovered from an illness, you won’t be forbidden from entering. 

Even if you’re currently affected by a chronic or recurring condition like multiple sclerosis or arthritis, you can come to the United States. USCIS is only focused on illnesses that can be transmitted to other people and illnesses that can cause someone to harm themselves or others.

Who Needs Form I-693?

Anyone filing for permanent resident status in the United States needs to complete Form I-693 in its entirety and provide accompanying documentation. It needs to be completed no more than 60 days before you file for an adjustment of status with USCIS. 

It doesn’t cost any money to file Form I-693, but you’re responsible for paying a civil surgeon for your medical examination. Not every doctor can complete the Form I-693. You must use a civil surgeon designated by USCIS. There are many qualified civil surgeons in the United States who can perform the necessary medical examination for form I-693.

Who Is Inadmissible Under Form I-693?

The United States won’t allow people with Class A conditions to enter the United States on a permanent basis. If you’re found to have a “communicable disease of public health significance,” like tuberculosis, gonorrhea, or syphilis, you cannot become a permanent resident. This only applies to active conditions. If you have a curable sexually transmitted disease, you can become a resident of the country after the disease has been cured.

You can also be deemed inadmissible for “lack of proof of having received required vaccinations,” which means that you do not have a vaccination record. You can get the required vaccines and show proof of your vaccination record to satisfy this requirement. 

“Physical or mental disorders with associated harmful behavior or a history of associated harmful behavior” can also make you inadmissible. This doesn’t apply to people with mental health disorders like depression or anxiety if they’ve never attempted to harm themselves or others. In some cases, people with these disorders can request a waiver for exemption.

Lastly, people with drug or substance abuse disorders are not allowed to enter the United States. This does not apply to people who lawfully use prescription medication provided by a physician to treat a non-class A condition like lower back pain, arthritis, insomnia, or anxiety.

A past history of substance use issues doesn’t disqualify you from entering the United States. If you’ve sought treatment for the problematic use of alcohol or drugs or the abuse or medication and you no longer use the substance, your substance use is considered to be in remission.

What Vaccines Do I Need to Have?

The USCIS is looking for specific vaccines on your vaccination records, although there may be some cases where a specific vaccine is deemed unnecessary. The USCIS uses current immunization guidelines to determine which vaccines are necessary. Some vaccines won’t apply to everyone. 

You aren’t required to have voluntary vaccines like human papillomavirus (HPV). You’re also not required to have vaccinations deemed inappropriate for your age group. (For example, a shingles vaccine usually won’t be appropriate for teenagers. Most people over 60 don’t need a hepatitis B vaccine.) You also will not be required to receive a vaccination if it is contraindicated such as if you previously had a life-threatening reaction to the vaccine or one of its components or you’re pregnant. 

Common necessary vaccines include:

  • COVID-19
  • Diphtheria
  • Haemophilus influenzae type b (Hib)
  • Hepatitis A
  • Hepatitis B
  • Influenza
  • Measles
  • Meningococcal disease
  • Mumps
  • Pertussis
  • Pneumococcal disease
  • Polio
  • Rotavirus
  • Rubella
  • Tetanus
  • Varicella

As soon as COVID-19 vaccines became widely available, they were added to the list of required vaccines for Form I-693. Most people will need to have proof of full COVID-19 vaccination, and they have to supply that proof to their civil surgeon at the time of their medical examination. 

You can only use medical documents as proof of your vaccination. Your civil surgeon will not accept handwritten records or self-reporting. The information you provide needs to be able to be verified by a civil surgeon. If it appears that the information has been altered or forged, your vaccination records won’t count.

Waivers (or exemptions) to the vaccination requirement are extremely limited. Waivers are only granted if the vaccine is not medically appropriate, there is a nationwide shortage of the vaccine, or compliance with the vaccination requirements would be contrary to your religious beliefs or moral convictions. A waiver based upon religious belief or moral conviction is not easy to obtain. 

How Do You Complete Form I-693?

Your civil surgeon may ask you questions or require your assistance in completing Form I-693, but the responsibility is mainly theirs. The civil surgeon will follow the instructions provided by USCIS and respond accordingly. 

You and your civil surgeon must be certain that all of the information provided in Form I-693 is complete and accurate. If it isn’t, you may both face penalties.

What If There’s a Problem With Form I-693?

If USCIS needs more information about your Form I-693, they’ll contact you. You can work with the civil surgeon who performed your examination to provide more information or documentation. In some cases, you may need a new medical examination performed by a different civil surgeon.

What If My Form I-693 Is Rejected?

There are some reasons why your form I-693 is rejected that you’re capable of fixing. For example, if USCIS says you need a vaccine you don’t have, just get the vaccine. It’s better to do that before you file your paperwork than it is to file again and wait for processing. Always double-check before you submit anything to USCIS to make sure you haven’t forgotten anything.

If you were rejected because you were found to have something like a sexually transmitted infection that can be cured with antibiotics, complete your course of antibiotics. As soon as you test negative for the sexually transmitted infection, you’re no longer a threat to public health. 

If you don’t understand why your application was rejected or if the reason for your rejection is beyond your control, it’s best to contact an experienced immigration attorney to explore your options. 

There may be exceptions that can be made for your case, but you’re better off letting an immigration attorney make the argument on your behalf. For example, you may be eligible for a waiver if you have sincere religious beliefs or moral convictions that prevent you from receiving vaccinations.

If your Form I-693 is rejected for voluntary noncompliance, like the adamant refusal of necessary vaccines or refusal to treat a communicable disease, you won’t be allowed to enter the United States.

What Do You Do After You Complete Form I-693?

Form I-693 is an important step in becoming a lawful permanent resident. Once you’ve completed your prerequisites, you can move forward with the process. The civil surgeon will give you the Form I-693 in a sealed envelope. It is important not to open the envelope, but you should make sure your name and if applicable, alien number (A number) are written on the outside of the envelope. You can request a copy of what is in the envelope from the doctor. Your sealed Form I-693 must be filed with USCIS within 60 days of being signed by the civil surgeon. process if your form is rejected.

Do You Need Help With Form I-693?

If your Form I-693 was rejected, if you need an exemption or a waiver, or if you need help understanding the process of becoming a permanent resident, the Cohen, Tucker & Ades team is here for you. Our compassionate team has decades of experience helping immigrants navigate the path of permanent residency and United States citizenship. Contact us now for a consultation.


Vaccinations for Adults — You’re never too old to get vaccinated! |

Vaccination Technical Instructions for Civil Surgeons | CDC

Form I-693, Instructions for Report of Medical Examination and Vaccination Record | USCIS


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