I-693, Report of Medical Examination and Vaccination Record

ALERT: Effective Oct. 1, 2021, applicants subject to the immigration medical examination must complete the COVID-19 vaccine series and provide documentation of vaccination to the civil surgeon in person before the civil surgeon can complete an immigration medical examination and sign Form I-693, Report of Medical Examination and Vaccination Record. This guidance applies prospectively to Form I-693 signed by civil surgeons on or after Oct. 1, 2021. Read our web alert for more information: COVID-19 Vaccination Required for Immigration Medical Examinations.

If you are applying for adjustment status to become a lawful permanent resident, use this form to establish that you are not inadmissible to the United States on public health grounds.

A list of those health grounds can be found in section 212(a)(1) of the Immigration and Nationality Act. For more information on the validity of Form I-693, see the USCIS Policy Manual Volume 8, Part B, Chapter 4.