Form I-693 is the medical exam USCIS requires of every adjustment-of-status applicant. A designated civil surgeon does it. It is limited to communicable diseases, required vaccinations, certain mental health conditions and substance abuse. Most delays come from missing vaccine records, TB testing and incomplete papers.
The I-693 immigration medical exam is one of the last hurdles before your green card. It is also one of the easiest places to lose weeks to a mistake you could have stopped.
What is the I-693 medical exam?
USCIS requires every adjustment-of-status applicant to complete Form I-693. It is a medical exam done by a designated civil surgeon. The exam checks only for the things immigration law cares about. Those are certain communicable diseases, required vaccinations, mental health conditions associated with harmful behavior, and substance abuse. It is not a physical. Your general health is not being graded.
What are the most common reasons I-693 exams get delayed?
Vaccinations. The CDC’s immunization requirements for immigration are stricter than the usual adult shot schedule. They are more specific, too. The usual problem is missing paperwork, not missing immunity. Bring every vaccine record you have, in any language.
Tuberculosis testing. All applicants age 2 and older require TB screening. This is typically an IGRA blood test. A positive result triggers a chest X-ray and more paperwork. Do you have a history of BCG vaccination or a prior positive test? Bring those records.
Incomplete personal documents. You’ll need a government photo ID and your vaccination records. Bring any medical history for long-term (chronic) conditions too. Good records can turn many visits into a single one.
How should I prepare for the I-693 medical exam?
Gather your records first. Book second. Applicants who arrive with a complete file routinely finish faster. They avoid the follow-up loop entirely. Not sure your records are enough? Text our office before your visit. A two-minute question can save two weeks.
Related reading: USCIS Medical Exam Is Not a Physical: What It Is · Vaccination Gaps: The #1 Cause of I-693 Delays · I-693 Exam Money-Back Guarantee in St. Louis · I-693 Immigration Medical Exam Cost — $390 Flat, St. Louis
Frequently Asked Questions
Do I need an appointment for the I-693 exam?
Yes. Booking ahead lets us check what papers you need in advance. That way we can complete most exams in a single visit.
What should I bring to my immigration medical exam?
Bring a government photo ID and all vaccination records in any language. Bring any prior TB test results. Bring papers for any chronic medical conditions. Include a list of the drugs you take now.
Which TB records to bring, and why they matter, is covered in TB Testing and Treatment in the I-693 Exam: What St. Louis Applicants Must Know.
How long does the I-693 process take?
With complete records, the exam itself takes under an hour. Lab results typically come back within days. Then the sealed I-693 is prepared for your application.
What medical tests are done for the I-693?
The exam checks only what immigration law cares about. That means certain communicable diseases, required vaccinations, mental health conditions associated with harmful behavior, and substance abuse. It is not a physical, and your general health is not graded. Every applicant age 2 and older is screened for TB. This is typically done with an IGRA blood test. A positive result leads to a chest X-ray.
How much does the I-693 exam cost?
The I-693 exam at our St. Louis office is $390, and a follow-up visit is $190. Arrive with a complete file: government photo ID, every vaccine record you have in any language, and any prior TB test results. That is how applicants routinely finish faster and avoid the follow-up loop.
Watch the full video above, and explore the rest of the series on our YouTube channel.
TB Testing Is Where Green Card Exams Stall — Don’t Walk In Blind explains why so many exams stall at TB testing.
Schedule Your Exam in St. Louis
Schedule Your Exam Text (314) 886-5902 Call (314) 960-9100
Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
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💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400
This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — USCIS-designated civil surgeon (CSID 111051), board certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed September 2026.