accepted Form I-693 — USCIS accepts Form I-693 when the medical examination is properly conducted by a designated civil surgeon, all required sections are complete, vaccinations are properly documented (or valid waivers included), and the form is submitted within the validity period; below is a practical guide for attorneys, paralegals, and clients.
— USCIS acceptance standards & best practices
By Brian D. Lerner — What it means for USCIS to accept Form I-693 (Report of Medical Examination and Vaccination Record), common pitfalls, and how counsel and clients should prepare to minimize delays.
What is Form I-693?
First, Form I-693 is the Report of Medical Examination and Vaccination Record used in immigration cases, most commonly for adjustment of status (green card) applications. Next, the purpose of the form is to ensure that an applicant does not have medical conditions that make them inadmissible to the United States under public-health grounds. Therefore, knowing what USCIS expects on the form is essential to avoid RFEs, rejections, or delays. See the official USCIS Form I-693 page for the most recent edition and instructions.
When is an I-693 “accepted” by USCIS?
An I-693 is typically considered “accepted” when four key conditions are met:
- It is completed on the current USCIS form edition (check USCIS I-693 page for updates).
- A designated **civil surgeon** completes the medical examination and signs the form.
- Required vaccinations are documented or valid waivers/exemptions are included (for example, religious or medical grounds where permitted).
- The form is submitted while the I-693 is still valid (generally within **2 years** of the civil surgeon’s signature, but USCIS may enforce shorter local times in some contexts).
Common mistakes that lead to non-acceptance
However, USCIS commonly rejects or issues RFEs for I-693 forms for the following reasons: (1) missing civil surgeon signature; (2) use of an outdated edition of the form; (3) incomplete vaccination records; (4) missing supporting lab results; (5) illegible entries; or (6) submission after the form’s acceptance window has expired. Therefore, review each form carefully before submission to avoid unnecessary delays.
Vaccination documentation details
Moreover, the vaccination section is one of the most common stumbling points. In addition to standard vaccine requirements (MMR, Tdap, varicella, etc.), USCIS requires age-appropriate vaccinations as listed in the latest CDC Technical Instructions. Consequently, applicants should bring complete immunization records to the civil surgeon appointment, including dates and lot numbers where available. If records are incomplete, the civil surgeon can administer required vaccines or document acceptable waivers per USCIS/CDC rules.
Medical exam — what the civil surgeon does
Next, the civil surgeon will review the applicant’s health history, conduct a physical exam, and order any necessary lab tests (for example, TB screening, blood tests). The surgeon also reviews vaccination status and fills out the Form I-693 accordingly. Therefore, it’s essential to select a USCIS-designated civil surgeon and to arrive prepared with all medical records and immunization histories. You can find a civil surgeon near you via the USCIS locator tool.
How I-693 interacts with adjustment of status
When filing for adjustment of status (Form I-485), USCIS generally wants an accepted I-693 before final action is taken, because public-health inadmissibility is one of the grounds that can prevent approval. Therefore, many attorneys advise submitting the I-693 with the I-485 packet or soon after, depending on local field-office norms and the timing of biometrics. Always check the latest USCIS guidance on when to submit I-693 to avoid it being rejected or separated from the primary file.
How long is an I-693 valid?
Generally, an I-693 sealed by a civil surgeon is valid for **2 years** from the date of signature. However, USCIS policy and local field office practices can affect how long a given I-693 will be accepted, and some offices may enforce tighter timelines in practice. If the form expires before adjudication, a new civil surgeon exam will be necessary and the form must be resubmitted. Know the signing date and plan submission accordingly.
Quick reference — acceptance criteria
| Criterion | Why it matters |
|---|---|
| Current edition of Form I-693 | Older versions may be rejected outright; USCIS updates forms regularly. |
| Civil surgeon signature | Without a valid signature, USCIS won’t accept the form. |
| Required vaccinations documented | Ensures compliance with public-health requirements. |
| Submitted while still valid | Expired forms are not accepted and must be redone. |
Intake & preparation checklist
- Record client identifiers (name, A-number, date of birth, contact info).
- Confirm the correct edition of Form I-693 from the USCIS site.
- Select a USCIS-designated civil surgeon and schedule the medical exam.
- Gather all immunization records (school records, passports, prior medical records).
- Bring lab reports (e.g., TB tests) or arrange for them at the civil surgeon visit.
- Verify that the civil surgeon completes and signs all relevant fields and seals the I-693.
- Calculate the acceptance window from the signature date and plan when to file.
Frequently asked questions
What happens if USCIS rejects my I-693?
USCIS will generally send a notice explaining why the form wasn’t accepted (e.g., missing signature, outdated edition). After fixing the issue (often requiring a new civil surgeon visit), you can resubmit the I-693. Plan accordingly to avoid filing late with Form I-485.
Can I submit the I-693 before my adjustment interview?
Yes. Many attorneys advise submitting the I-693 with the I-485 packet or soon after, but check field-office practices. Submitting early (while still valid) reduces the likelihood of RFEs or delays before the interview or final action.
Are all civil surgeons the same?
No. Civil surgeons are designated by USCIS but may vary in how they communicate requirements and collect records. Choose one with strong reviews or recommendations from immigration attorneys and arrive prepared with complete health and vaccination records.