If you’re preparing an adjustment of status application or another immigration benefit that requires a medical exam, you’ve probably run into the name “Form I-693” on the USCIS website or in your attorney’s checklist. But what actually is this form, who is allowed to fill it out, and why does everyone warn you not to open the envelope it comes in? Here’s a plain-language look at Form I-693 as a document and a paperwork process — separate from what happens during the exam itself.

What Is USCIS Form I-693?

Form I-693 is USCIS’s official “Report of Immigration Medical Examination and Vaccination Record.” It’s the standardized document a designated civil surgeon uses to record the results of your immigration medical exam and to verify your vaccination history against USCIS’s requirements.

Form I-693 itself isn’t something you fill out at home. It’s completed by the civil surgeon who examines you, based on your physical exam, any required lab work, and a review of your vaccination records. Applicants most commonly need Form I-693 as part of a Form I-485, Application to Register Permanent Residence or Adjust Status (the “green card” application), though it can also apply to certain other immigration benefit requests. Because requirements can vary by case type and circumstance, always confirm with USCIS or your immigration attorney whether your specific application requires Form I-693 and how it should be submitted.

Who Is Authorized to Complete and Sign Form I-693?

Not just any physician can complete Form I-693. USCIS requires the exam to be performed — and the form signed — by a physician who has been specifically designated by USCIS as a civil surgeon. This is a formal designation granted directly by USCIS to an individual physician; it is not automatically extended to every doctor at a clinic, and it is not a designation a clinic itself can hold.

At PassQual Health, Dr. Hendry J. Perez Pascual, MD, is personally the USCIS-designated civil surgeon who performs and signs the Form I-693 exam. If you’re being examined at PassQual, your exam is conducted directly under his designation.

The Sealed Envelope: Why Your Form I-693 Must Stay Closed

Once your civil surgeon completes Form I-693, USCIS requires that it be provided to you in a sealed, unopened envelope for you to submit along with your application package. This is a standard, well-documented part of the USCIS process — the form is considered valid only if it reaches USCIS in the same sealed condition the civil surgeon provided it in.

If the envelope is opened, tampered with, or otherwise not sealed when USCIS receives it, this can create delays or additional questions in your case, since USCIS can no longer confirm the document wasn’t altered after the civil surgeon completed it. In practice, this means:

  • Do not open the envelope “just to check” what’s inside.
  • Do not remove the form to photocopy it before sealing — ask your civil surgeon’s office about their process for keeping a copy on file, if you’d like one.
  • Keep the sealed envelope in good condition (not bent, torn, or exposed to moisture) until it’s time to submit it with your application.
  • If you’re working with an immigration attorney, ask them how they prefer to receive the sealed envelope for inclusion in your filing.

USCIS Filing Rules Can Change — Always Confirm Directly

USCIS periodically updates its policies around Form I-693, including details like filing timing and how long a completed exam remains valid for use with an application. Because these rules can and do change, this article intentionally doesn’t state specific timeframes or filing windows — the accurate answer is whatever USCIS’s current guidance says on the day you file.

Before you submit your application, confirm the current requirements directly with USCIS or with a qualified immigration attorney. USCIS’s official page for the form, including current instructions and any recent policy updates, is available at uscis.gov/i-693.

Get Your Form I-693 Completed at PassQual Health

PassQual Health’s founder and Medical Director, Dr. Hendry Pascual, is the USCIS-designated civil surgeon who personally performs and signs every Form I-693 exam at our Miami Gardens clinic. The exam is $190 per person, all-inclusive — covering the physical exam, all required labs, and vaccination-record verification (a chest X-ray, if needed, is quoted separately). Our team works with patients bilingually in English and Spanish throughout the entire process, from scheduling through the moment you leave with your sealed envelope.

For a complete overview of what the exam involves, how to prepare, and what to expect at your visit, see our Immigration Medical Exam (Form I-693) page, or call us at 786-677-9922 to book your appointment.

Frequently Asked Questions About Form I-693

What is Form I-693?

Form I-693, officially titled “Report of Immigration Medical Examination and Vaccination Record,” is the USCIS form a civil surgeon uses to document your immigration medical exam results and vaccination status. It’s most commonly filed alongside Form I-485 adjustment of status applications.

Who can sign Form I-693?

Only a physician who holds USCIS’s civil surgeon designation can complete and sign Form I-693. At PassQual Health, that’s Dr. Hendry Pascual, our founder and Medical Director.

Why is Form I-693 sealed?

USCIS requires the completed form to be given to you in a sealed, unopened envelope so that it reaches USCIS in the same condition your civil surgeon provided it — this protects the integrity of the document for your case.

What happens if I open the envelope?

Opening or tampering with the sealed envelope can cause processing problems, since USCIS can no longer confirm the form wasn’t altered after your civil surgeon signed it. Leave the envelope sealed and submit it as provided.

Where do I file Form I-693?

Form I-693 is typically submitted as part of your broader application package, such as with Form I-485. Because exact filing instructions and timing can change, confirm the current process directly with USCIS at uscis.gov/i-693 or with your immigration attorney before you file.

This article is for general informational purposes only and is not legal or medical advice. Immigration filing requirements can change, and every case is different — always confirm current requirements with USCIS or a qualified immigration attorney. For questions specific to your Form I-693 exam at PassQual Health, call us at 786-677-9922.