How long your I-693 is good for, and when to file it

If a civil surgeon signed your Form I-693 on or after November 1, 2023, the form has no fixed expiration date. USCIS treats it as evidence for one application only — the one you file it with — and for the whole time that application is pending. You must file it together with your Form I-485. If you do not, USCIS may reject your Form I-485.

That is the rule as of September 22, 2026, when we last checked these sources. It comes from the USCIS Policy Manual, Volume 8, Part B, Chapter 4 and the USCIS Form I-693 page. This article is general information from USCIS, not advice about your own case.

USCIS's wording is that, in general, a properly completed Form I-693 signed by a civil surgeon on or after November 1, 2023 "can only be used as evidence to show that the applicant is not inadmissible under the health-related grounds for the entire period the immigration benefit application with which the Form I-693 is submitted is pending."

Two things follow:

• Your form does not run out while your application is waiting to be decided. No clock counts down against you.
• It belongs to that one application. You cannot hold on to it and reuse it for a different application later.

USCIS also keeps discretion. If an officer has reason to believe your medical condition has changed since the civil surgeon signed, or that the form no longer reflects your condition, the officer may ask for further evidence or for a new or updated Form I-693.

Source: USCIS Policy Manual, Volume 8, Part B, Chapter 4, current as of September 18, 2026.

The Instructions for Form I-693, edition 01/20/25, still say: "Form I-693 remains valid for two years from the date of the civil surgeon's signature." That sentence is widely repeated, and it is why many people expect two years.

Two years is still the right answer for one group. USCIS says a Form I-693 signed by a civil surgeon before November 1, 2023 "retains evidentiary value for 2 years from the date of the civil surgeon's signature" — though a form signed before that date passed its two-year mark in October 2025.

For a form signed today, the Policy Manual governs. USCIS's own Form I-693 page says: "For more information on the validity of Form I-693, see the USCIS Policy Manual Volume 8, Part B, Chapter 4." The Policy Manual chapter was last changed by a policy alert dated June 11, 2025 and is current as of September 18, 2026; the instructions carry the 01/20/25 edition date. If you are reading this well after the date below, check that chapter, because that is the page USCIS keeps current.

That June 2025 update, USCIS Policy Alert PA-2025-08, says so directly: "The guidance contained in the Policy Manual is controlling and supersedes any related prior guidance." So where the Policy Manual and the older instructions disagree, the Policy Manual — and the no-fixed-expiration rule above — is the one that governs.

The USCIS Form I-693 page says: "Effective Dec. 2, 2024, you must submit Form I-693, or a partial Form I-693 (such as the Vaccination Record), and you must submit it with your Form I-485. Otherwise, we may reject your Form I-485."

A rejection is not a denial: USCIS does not decide your case, it sends the package back. You lose the filing date and file again.

If USCIS rejects a package and returns it with the Form I-693 envelope opened, USCIS says you may refile using that original opened form, in its original envelope with the civil surgeon's supporting documents, together with a copy of the rejection notice.

How to hand the sealed envelope in, by mail or online, is under "How it works" on our immigration medical exam page.

USCIS used to require the civil surgeon's signature to be dated no more than 60 days before you filed the underlying application. That requirement was temporarily waived beginning December 9, 2021, and permanently removed on March 31, 2023.

It has not returned, so as of September 22, 2026 there is no rule requiring your exam to fall within a set number of days before you file.

Source: USCIS Policy Manual, Volume 8, Part B, Chapter 4.

USCIS says: "If the immigration benefit application with which the Form I-693 is submitted is withdrawn or denied, then an applicant needs to submit a newly completed and signed Form I-693 with any future immigration benefit application that requires an alien to demonstrate that he or she is not inadmissible on health-related grounds."

In plain terms: a withdrawn or denied case means a new exam and a new form for the next application. The old one does not carry over.

Working only from what USCIS publishes, as of September 22, 2026:

• There is no 60-day window to hit, so the exam is not a race against a filing deadline.
• You do need the sealed envelope in hand before you file, because the form has to go in with your Form I-485.
• Check which edition of the form to use before you print it. The civil surgeon is required to use, in almost all cases, the edition in use on the day they sign. USCIS accepts only the 01/20/25 edition for signatures dated July 3, 2025 or later, and the current edition is listed on the USCIS Form I-693 page.

For the day itself, see Full guide: what to bring to your I-693 exam.

Dr. Chang is a USCIS-designated civil surgeon. He sees adults 18 and over, and exams are by appointment only, so please call the office to book.