What to bring to your I-693 exam

If you are applying for a Green Card from inside the United States (adjustment of status, on Form I-485), USCIS requires Form I-693, the Report of Immigration Medical Examination and Vaccination Record. Only a USCIS-designated civil surgeon can complete it. Some applicants who already had a medical exam abroad, such as certain refugees, need only part of the form; the USCIS Form I-693 page explains who.

Dr. Chang is a civil surgeon. He sees adults 18 and over, and exams are by appointment only, so please call the office to book. This guide covers what to bring and how to prepare the form. It is general information from USCIS and the CDC, not advice about your own case.

The CDC's rules for civil surgeons say which records count:

• A personal vaccination record, or a copy of a medical chart with entries made by a physician or other appropriate medical personnel.
• Each dose must show the full date it was given: month, day and year.
• The record must not appear to have been altered, and the dates should seem reasonable.
• A dose you remember getting but have no written record of does not count.

The CDC's rules also accept laboratory evidence of immunity to measles, mumps, rubella, hepatitis A, hepatitis B, polio (for polio, the test must cover all three types of poliovirus) and varicella (chickenpox) when there is no acceptable vaccination record for that disease. If you have results from a blood test like this, bring them too.

If your records are missing or incomplete, the CDC's rules say you do not have to finish every vaccine series before you adjust status. Instead, you need at least one dose of each required vaccine you are not up to date on. Which vaccines are required depends on your age. USCIS's instructions say you may ask your own doctor to give those vaccines after the civil surgeon has evaluated you, and then show those records to the civil surgeon to note on Form I-693.

Source: CDC Vaccination Technical Instructions for Civil Surgeons and USCIS Instructions for Form I-693.

To find out how this works at our office, please call and ask before your exam.

The CDC's rules say the responsibility lies with the applicant to provide reliable English translations of all records. If any of your vaccination or medical records are in another language, bring an English translation with them.

Source: CDC Vaccination Technical Instructions for Civil Surgeons.

The exam includes a TB blood test (IGRA). If you have a TB history, written documentation matters. The CDC's rules for civil surgeons say:

• A previous positive TB blood test (IGRA). Written documentation from a physician of a previous positive IGRA means you do not need a new one, though a chest X-ray is then required. The documentation must include the date of the test, the type of IGRA, the results in standard units of measurement, the interpretation (positive), and the testing physician's name, signature and office information.
• A previous positive skin test (TST). This does not replace the IGRA; you must still have one.
• Completed treatment. Bring documentation of your diagnosis and of completing treatment, whether for TB disease or for latent TB infection. If you report completing treatment for TB disease but have no documentation, you are evaluated as if you had not had TB disease.
• Earlier chest X-rays. A chest X-ray reading must include a comparison with prior chest X-rays, if available, so bring any earlier chest X-ray reports or images you have.
• A TB diagnosis in the United States. The civil surgeon should try to get those records from the state or local health department, or ask you to get them and bring them.

Source: CDC Tuberculosis Technical Instructions for Civil Surgeons.

• Download the form from the USCIS Form I-693 page. That page says which edition USCIS accepts, based on the date the civil surgeon signs. The edition date is printed at the bottom of each page of the form.
• Fill in only Part 1, Information About You, plus your name and A-Number (if you have one) at the top of each page. If you do not have an A-Number, write "N/A." The civil surgeon, and any other doctors, clinics or health departments you are referred to, complete the other parts.
• Type or print legibly in black ink.
• Do not sign the form yet. USCIS's instructions say not to sign it until the civil surgeon tells you to, and that you must sign in the civil surgeon's presence.

Source: USCIS Instructions for Form I-693 and the USCIS Form I-693 page.