A Complete Guide to the Immigration Medical Exam, Required Lab Tests, and USCIS Compliance Immigrating to the United States involves more than legal paperwork—it also requires a federally mandated medical evaluation to protect public health and confirm eligibility for permanent residency. One of the most critical (and frequently misunderstood) steps in this process is Form I-693, officially titled Report of Medical Examination and Vaccination Record. This guide is designed to be the most comprehensive and practical resource available for immigrants preparing for their I-693 medical exam. Whether you are filing an adjustment of status application or responding to a USCIS request, this article explains exactly what to expect, which lab tests are required, how to avoid delays, and how to complete your exam efficiently. We also specifically address applicants seeking an immigration medical exam in Indianapolis, Carmel, Fishers, Zionsville, and Westfield, ensuring local relevance and clarity.
What Is Form I-693 and Why Is It Required?
Form I-693 is required by U.S. Citizenship and Immigration Services to verify that applicants for permanent residence do not have medical conditions that could pose a public health risk or make them inadmissible under U.S. immigration law. The form must be completed and signed by a USCIS-designated civil surgeon. Exams performed by non-authorized providers are automatically rejected, even if all medical information is otherwise correct.
Who Needs an I-693 Immigration Medical Exam?
You will generally need an I-693 exam if you are:
• Applying for a Green Card through adjustment of status
• Submitting medical documentation after receiving a USCIS Request for Evidence (RFE)
• Re-filing because a prior exam was incomplete or improperly completed Validity Note Under current USCIS policy, an I-693 signed by a civil surgeon after your I-485 filing does not expire, provided there are no material changes to your medical condition. 1. Form I-693, signed by a authorized civil surgeon on or after Nov. 1, 2023, remains valid indefinitely unless a USCIS officer requests a new one.
What Happens During an I-693 Medical Exam?
The immigration medical exam follows a standardized federal protocol and includes four
core components:
1. Medical History Review
The civil surgeon will review:
• Past and current medical conditions
• Prior surgeries or hospitalizations
• Mental health history
• Alcohol or substance use history
Honesty is critical. Disclosure does not automatically result in denial, but omissions can
cause serious delays.
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2. Physical Examination
This is a general medical assessment that includes:
• Height, weight, and blood pressure
• Vision screening
• Evaluation for signs of communicable disease
This is not a diagnostic exam but a screening for public health concerns.
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3. Required I-693 Lab Tests (Critical Section)
Federal law mandates specific laboratory testing based on age and risk category. These
tests are non-negotiable.
Tuberculosis (TB) Screening
• Required for all applicants age 2 and older
• Typically performed using an IGRA blood test
• Chest X-ray required if the screening test is positive
Active TB must be fully treated and cleared before USCIS approval.
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Syphilis Testing
• Required for applicants ages 18–44
• Performed via blood testing (RPR or equivalent)
• Positive results require confirmation testing and documented treatment
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Gonorrhea Testing
• Required for applicants ages 18–44
• Conducted using a urine NAAT test
• Positive tests must be treated prior to form completion
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4. Vaccination Review and Requirements
USCIS requires proof of age-appropriate vaccinations, which may include:
• MMR (Measles, Mumps, Rubella)
• Tdap or Td
• Varicella (Chickenpox)
• Influenza (seasonal requirement)
• Hepatitis B (depending on age)
• COVID-19 (per current USCIS policy)
If documentation is missing, the civil surgeon may:
• Order blood titers to verify immunity
• Administer vaccines during your visit
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Mental Health and Substance Use Evaluation
This portion of the exam is often misunderstood and causes unnecessary anxiety.
USCIS is specifically evaluating for:
• Mental health conditions associated with harmful behavior
• Active substance abuse or dependency
• Conditions that pose a public safety risk
A history of anxiety, depression, therapy, or medication does not automatically impact
immigration eligibility.
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Common Reasons I-693 Forms Are Rejected
Avoid these frequent errors:
• Using a provider who is not a USCIS-designated civil surgeon
• Missing or incomplete lab results
• Inadequate vaccination documentation
• Opening or altering the sealed I-693 envelope
• Submitting the form before all labs are finalized
Even small mistakes can delay your case by months.
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How Long Does the I-693 Process Take?
Step Typical Timeline
Medical appointment 60 minutes
Lab results 2–5 business days
Final form completion 2–4 days after labs
Clinics with coordinated lab services typically offer faster turnaround and fewer errors.
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Immigration Medical Exams in Central Indiana
We provide I-693 immigration medical exams for individuals and families throughout:
• Indianapolis
• Carmel
• Fishers
• Zionsville
• Westfield
communication throughout every step.
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Why Accuracy Matters With Form I-693
lab result, vaccine entry, and signature must meet strict federal standards. When
completed correctly, it prevents delays, RFEs, and unnecessary stress during the