Immigration Medical Exam Guide: What to Expect at the I-693 Exam

The immigration medical exam is the part of a green card application that happens in a clinic: a USCIS-designated civil surgeon examines you, screens for the conditions U.S. immigration law is concerned with, checks your vaccination record against the CDC’s list and seals the completed Form I-693 for you to file. This guide walks through it in order — what to bring, what is screened at each age, what can delay the form and how long it stays valid in 2026.

UrgentMed does the exam as a walk-in visit at its Davie and Plantation clinics — see the immigration medical exam page for hours and what the visit includes.

What to expect at the immigration medical exam, step by step

1. Get the form. Download the current edition of Form I-693 from uscis.gov/i-693 and fill in your own information, but do not sign it — you sign in front of the civil surgeon.
2. Gather your records. Photo ID, every vaccination record you have from any country (with a reliable English translation of anything in another language), any earlier TB test or chest X-ray report, and a list of your medications and conditions.
3. History and examination. The civil surgeon asks about your medical history, including mental health and substance use, and examines your eyes, ears, nose and throat, heart and lungs, abdomen, lymph nodes, skin and extremities.
4. Screening by age. A TB blood test for everyone two years and older, a syphilis test from 18 to 44 and a gonorrhea test from 18 to 24; outside those ages a test is done only when there is a reason to suspect infection.
5. The CDC’s list for immigrants. Your record is compared with the CDC’s age-based list; a dose you are missing can be given at the visit when the clinic stocks it, or proof of immunity drawn for the diseases where the CDC accepts it.
6. Results and the sealed form. When the results are back — usually a few business days — the civil surgeon completes and signs the I-693 and seals it in the envelope USCIS requires, for you to file unopened with your I-485.

Before the visit: the form, your records and what to bring

Most delays start before the exam. Three things make the difference:

• The current form, unsigned. USCIS posts the current edition at uscis.gov/i-693. Fill in your part in advance; the civil surgeon completes the rest and you sign it at the visit.
• Every vaccination record, translated. Records from any country count when they show the date each dose was given; for a record in another language, the CDC makes a reliable English translation the applicant’s responsibility. Valid documented doses usually do not have to be repeated.
• Earlier TB results. Bring any previous TB test or chest X-ray report. If you had the BCG vaccine as a child, the TB blood test is not affected by it — the CDC calls blood tests the preferred test for people who received BCG.

At the visit: history, examination and screening by age

The exam follows the CDC’s Technical Instructions for civil surgeons. It is narrower than a full check-up: it looks for the specific conditions immigration law is concerned with.

• Tuberculosis: a TB blood test (IGRA) for applicants two years and older. A chest X-ray follows a positive result, and is required whatever the blood test shows for known HIV infection or signs of TB. Children under two have a history and examination and are tested only if they have signs of TB or known HIV.
• Syphilis: a blood test for applicants 18 to 44; younger or older applicants only when infection is suspected.
• Gonorrhea: a urine test (or a self-collected swab) for applicants 18 to 24; others only when infection is suspected.
• Substance use: there is no routine drug test. The civil surgeon asks about substance use and examines you, and orders laboratory testing only when the history or the examination calls for it.
• Other conditions: the civil surgeon also looks for Hansen’s disease and for physical or mental disorders associated with harmful behavior.

The CDC’s required list for immigrants, and how records count

The CDC’s list covers 15 diseases — diphtheria, tetanus and pertussis; polio; measles, mumps and rubella; varicella; hepatitis A and B; Hib; meningococcal disease; pneumococcal disease; rotavirus; and influenza in season — and each applies only at the ages the CDC sets (the CDC’s requirements by age). COVID-19 is not on the current list.

A dose counts when your record shows the date it was given. For measles, mumps, rubella, varicella, polio and hepatitis A and B, a blood test that shows immunity (a titer) can take the place of the dose. When a dose is not medically appropriate, the civil surgeon records a blanket waiver for one of the four reasons the CDC allows: not appropriate for your age, a contraindication (some doses are not given in pregnancy, for example), too little time since the previous dose, or the influenza vaccine not being available out of season.

At UrgentMed, the doses the clinic stocks — tetanus, hepatitis B, MMR, varicella and polio, and flu in season — can be given at the visit and recorded on the form; the civil surgeon tells you if a dose on your list has to come from elsewhere.

After the visit: results, follow-up and the sealed envelope

• Results usually return in a few business days. If one needs follow-up — a chest X-ray after a positive TB blood test, treatment for an infection, a dose that is missing — you are told what comes next before the form is completed.
• If the civil surgeon suspects infectious TB disease, the CDC requires a referral to the county health department, and the I-693 is signed only after you return with the health department’s results.
• The civil surgeon completes and signs the form, gives you a copy for your records and seals the original in the USCIS envelope. Do not open it — an opened envelope is rejected.
• Since December 2, 2024, the sealed I-693 goes in with your Form I-485 at filing.

What can delay the I-693 — and how to avoid it

• Untranslated or undated records. Bring an English translation of anything in another language, and every card or booklet you have.
• An old edition, or a form signed early. Print the current edition and leave the signature for the visit.
• A positive TB blood test. The chest X-ray adds a step; an earlier X-ray report helps.
• A dose the clinic does not stock. Ask at check-in which doses your record still needs, so you can plan where to get them.
• An opened envelope. Keep it sealed until it goes in with the I-485.

How long the I-693 stays valid in 2026

Under the USCIS policy update of June 11, 2025, an I-693 the civil surgeon signed on or after November 1, 2023 stays valid while the Form I-485 it was filed with is pending; it cannot be reused for a later application. Because it has to be filed together with the I-485, plan the exam with your attorney so the sealed form is ready when the rest of the application is.

Where to get the exam in Broward

UrgentMed does the exam as a walk-in visit, seven days a week, at 5149 S University Drive in Davie and 10199 Cleary Boulevard, Suite 10, in Plantation — civil surgeons at both, the TB blood test, lab draw and chest X-ray in the building, Spanish-speaking staff. Hours and details: immigration medical exam in Davie and Plantation. For law firms: I-693 exams for your clients.