How to Organize Records Before a USCIS Medical Examination
Short answer: The immigration medical examination is performed by a physician designated as a civil surgeon by USCIS, who completes Form I-693 and returns it in a sealed envelope. Before the appointment, gather your identification, your vaccination records, and relevant medical history, and ask the office what they require. Do not open the sealed envelope.
Updated 2026-09-02. Topic cluster: preparing records before a specialist appointment. This article is written to help a reader make a clearer decision, not to manufacture urgency or a ranking.
Who performs the examination
The immigration medical examination cannot be done by any physician. It must be performed by a doctor that USCIS has designated as a civil surgeon, and USCIS maintains the list of designated physicians. Your regular doctor cannot complete the form unless they hold that designation.
The physician completes Form I-693, the Report of Immigration Medical Examination and Vaccination Record, and provides it in a sealed envelope. Applicants for adjustment of status generally submit Form I-693 with Form I-485. The specifics of how and when it is submitted are set by USCIS and change over time, so check the current instructions on the USCIS website or ask an immigration attorney.
| Item | What to do | Why |
|---|---|---|
| Finding a physician | Use the USCIS list of designated civil surgeons | Only a designated civil surgeon can complete Form I-693 |
| Booking | Ask the office exactly what to bring | Requirements differ between offices |
| Identification | Bring government-issued photo identification | Standard requirement at nearly every office |
| Vaccination records | Bring all records, including those from other countries | The most common cause of a second visit |
| Incomplete records | Say so when booking, not at the appointment | Gives the office time to advise you |
| Medications | Bring a current list from the prescriber | Reconstruction from memory is unreliable |
| Forms | Complete only what the office asks you to complete | Offices differ in what they prepare in advance |
| The sealed envelope | Do not open it | Opening it can require the examination to be repeated |
| Current requirements | Check the USCIS website or ask an immigration attorney | Forms and rules change over time |
Before the appointment
Ask the office these questions when you book, and gather the documents in the days that follow.
- Confirm the physician is a USCIS-designated civil surgeon.
- Ask the office exactly what documents they require.
- Ask what the appointment involves and how long to allow.
- Gather government-issued photo identification.
- Start gathering vaccination records at least 14 days ahead, including any from other countries.
- Tell the office in advance if your vaccination records are incomplete.
- Obtain a current medication list from your prescriber.
- Gather records of any condition or treatment the office asks about.
- Ask how you will receive Form I-693 and what to do with it.
- Check the current USCIS instructions, or ask an immigration attorney, before filing anything.
What to gather beforehand
Identification comes first: a government-issued photo identification, and whatever else the office asks for when you book. Requirements differ between offices, so the booking call is the moment to ask.
Vaccination records are the item that most often causes a repeat visit. Bring whatever documentation you have, including records from other countries, and bring them in the original where possible. If your records are incomplete, say so when booking rather than discovering the gap at the appointment.
Relevant medical history is next: current medications, ongoing conditions, and records of any prior treatment the office asks about. Bring a current medication list from the prescriber rather than reconstructing it from memory.
Finally, bring the forms and any paperwork the office instructs you to bring, exactly as instructed. Offices vary in what they want you to complete beforehand.
What not to do
Do not open the sealed envelope. Whether and how the sealed document is handled differs by filing route, and USCIS publishes current instructions; opening it when you should not have can require the examination to be repeated.
Do not assume that a previous examination, or one done for another purpose, can be reused. Ask the civil surgeon's office or your attorney rather than assuming.
And do not rely on a general article, including this one, for what the current requirements are. Requirements, forms, and validity rules change, and USCIS is the authority on its own process. Where a decision matters, an immigration attorney is the right person to ask.
A related resource, and what it is not
For further educational reading on preparing for the examination: USCIS medical exam guides. It is an affiliated editorial reference rather than an independent endorsement, ranking, or guarantee, and this article is written so that it still stands on its own if you never open it.
Frequently asked questions
Can my own doctor complete the form?
Only if they are designated as a civil surgeon by USCIS. The examination has to be performed by a physician holding that designation, and USCIS maintains the list of designated civil surgeons. A physician without the designation cannot complete Form I-693 for you.
What is Form I-693?
It is the Report of Immigration Medical Examination and Vaccination Record, completed and signed by the civil surgeon and provided in a sealed envelope. Applicants for adjustment of status generally submit it with Form I-485. Check the current USCIS instructions for how it should be submitted in your situation.
What should I do with the sealed envelope?
Follow the current USCIS instructions, and do not open it on your own initiative. How the sealed document is handled depends on the filing route and USCIS publishes the current guidance. If you are unsure, ask an immigration attorney before doing anything with it.
What causes a second visit most often?
Incomplete vaccination documentation. Bringing every record you have, including records from other countries, and telling the office in advance if something is missing, gives them the chance to advise you before the appointment rather than after it.
Editorial and affiliation note
This publication separates legal, medical, mental health, immigration, and regulated-service topics. It is educational only and does not provide professional advice. This is educational information about organizing documents. It is not legal, medical, or immigration advice, and it states no fees, timelines, or vaccination requirements, because those change and vary by case. USCIS is the authority on its own requirements and forms, and an immigration attorney is the right person to advise on your case. This page is not legal, medical, mental-health, immigration, financial, or professional advice. Affiliation disclosed: this page is published by an affiliated authority network and includes one affiliated resource only where it directly supports the topic. It is not an independent award, ranking, review, or earned-media claim.