In June 2025 USCIS updated how it accepts Form I-693 (Report of Immigration Medical Examination). Key outcomes: for forms signed on or after November 1, 2023,
USCIS now ties the medical’s validity to the specific immigration application with which it was filed (generally Form I-485). Practically, that means an I-693 signed on/after Nov. 1, 2023
is valid only while the associated I-485 remains pending; if the I-485 is withdrawn or denied the I-693 becomes invalid and a new medical is required for a refiled application.
USCIS also set an edition requirement for the form (01/20/2025 edition mandatory as of July 3, 2025) and clarified vaccination and civil-surgeon procedures. Read this page for what applicants, civil surgeons, and intake teams must do now.
Accepted Form I-693 — USCIS Standards & 2025 Updates
What changed
- Validity rule: I-693s signed on or after Nov. 1, 2023 are only valid for the I-485 with which they were filed — valid while that application is pending; invalid if the I-485 is withdrawn or denied.
- Edition requirement: USCIS will accept only the 01/20/2025 edition of Form I-693 beginning July 3, 2025. (Until then, earlier editions may be accepted per USCIS guidance.)
- Civil-surgeon & vaccinations: CDC technical instructions remain the medical standard for civil surgeons; USCIS has separately waived the COVID-19 vaccination documentation requirement as of Jan. 22, 2025.
- Practical effect: applicants who refile after denial/withdrawal will generally need a new medical exam if their prior I-693 was signed on/after Nov. 1, 2023.
Why USCIS made the change (public-health & timeliness rationale)
USCIS explains the change as a public-health and timeliness measure — ensuring medical examinations are recent and reflect current medical evaluations and vaccination status
at the time of adjudication. By tying validity to the pending application, the agency reduces the chance that applicants will present stale medical exams much later in the process.
Practical guidance for applicants
If your I-693 was signed before Nov. 1, 2023
USCIS historically accepted certain earlier I-693s for a two-year window from the signature date; check the form’s signature date and confirm whether your case falls under the older acceptance window.
If in doubt, ask counsel whether a new exam is recommended to avoid delays. When refiling after a denial or withdrawal, anticipate that USCIS may require a new I-693 if the prior form is no longer valid.
If your I-693 was signed on or after Nov. 1, 2023
Expect the medical to be tied to the I-485 it was filed with; if that I-485 is denied or withdrawn, you will generally need a new medical before a new filing will be accepted. Consider:
- Submit your I-693 at the time you file I-485 when feasible, to avoid later requests for a new exam.
- Retain the civil surgeon’s contact details and the signed, sealed envelope (if applicable) because USCIS may ask about the exam’s provenance or request a re-submission under narrow conditions.
Guidance for civil surgeons & clinics
Civil surgeons should follow CDC Technical Instructions for civil surgeons (medical exam content, required vaccinations, and reporting). Clinics must:
- Use the current USCIS-approved edition of Form I-693 when completing exams (01/20/2025 edition becomes mandatory July 3, 2025).
- Keep clear records of the exam date, signature, and the edition used; maintain contact details for the civil surgeon on each exam.
- Note that USCIS announced a waiver regarding required documentation of COVID-19 vaccination as of Jan. 22, 2025 — follow USCIS/CDC guidance for any procedural notes on that change.
What intake teams and attorneys should do now
- When scheduling I-485 filings, encourage applicants to complete the I-693 medical and include it with the initial I-485 packet when possible.
- At intake capture: civil surgeon name, signature date, I-693 edition used, and whether any sealed envelope was provided.
- If an I-485 is denied/withdrawn, re-check the I-693 signature date before advising about re-filing — a new medical will often be necessary for forms signed on/after Nov. 1, 2023.
- Update your client advisories to note the July 3, 2025 edition requirement so applicants know to seek exams using the current edition after that date.
Quick reference table
| Issue | Rule |
|---|---|
| Form signed before Nov 1, 2023 | Older acceptance rules may apply — check signature date & edition used; consult counsel. |
| Form signed on/after Nov 1, 2023 | Valid only for the associated I-485 while pending; invalid if I-485 denied/withdrawn. |
| Form edition | Only 01/20/2025 edition accepted beginning July 3, 2025; update clinic forms accordingly. |
| COVID-19 vaccination documentation | USCIS announced waiver of documentation requirement as of Jan. 22, 2025 — follow USCIS/CDC guidance. |
Frequently asked questions
Q — If my I-485 is denied and I refile, will I need a new I-693?
If your I-693 was signed on/after Nov. 1, 2023, USCIS policy ties validity to the specific I-485: a denial or withdrawal generally means the I-693 is no longer valid and a new medical will be required when you refile. Confirm with counsel for exceptions in narrow administrative return/reject situations.
Q — What if USCIS returns the application as rejected (not denied) with the I-693 envelope opened?
USCIS has allowed narrow administrative exceptions (for example, when a package is returned for correction). If you receive a rejection notice with the original I-693 returned intact or with a return notice, consult guidance to see if re-submission is allowed without a new exam — these are limited circumstances.
Q — Which I-693 edition should civil surgeons use now?
Use the latest USCIS-approved edition. As of July 3, 2025 USCIS will accept only the 01/20/2025 edition — update clinic templates and ordering systems so patients get the correct edition after that date.
Resources & authoritative guidance
- USCIS: Alert — Changes to I-693 validity rules (policy change & FAQs).
- USCIS: Form I-693 page (filing guidance & details about who must submit).
- CDC: Technical Instructions for Civil Surgeons (medical exam standards).
- USCIS bulletin: Guidance for civil surgeons related to COVID-19 vaccine (waiver notice).