How to Prepare & Submit the Form I-693

How to fill out Form I-693 (For the Applicant)

The I-693 includes 10 parts. As the Applicant you only need to fill out Part 1 before your doctor appointment. You will also need to write your name and Alien Number (when you have one) at the top of each page of the form. This should be an 8 or 9 digit number starting with the letter A and can be found on any letters or notices you may have received from the Department of Homeland Security.

To fill out Part 1 you will need:

• Your full name (your legal name)
• Your address – the place you live, PO boxes will not work
• Your sex
• Your date of birth
• The city, town, or village in which you were born
• The country you were born in
• Your Alien Registration Number (A-Number) if you have one
• Your USCIS online account number, if you have one

As the Applicant you will also need to fill out Part 2. This part is where you give some contact information and sign the form. You MUST fill out this section with the civil surgeon present to witness you filling it out.

Form I-693 is included in Green Card Application Builder

Doctor Appointment

To find a USCIS certified surgeon:

• Go to uscis.gov
• Select “Find a Doctor”
• Enter your ZIP Code
• Click “Search”

A list of doctors in your area should appear. Select one and make an appointment by calling the number next to it.

How to fill out Form I-693 (For the Interpreter)

• You will be required to fill out Part 3. This includes:
• Your name
• The name and address of the business or organization (when applicable)
• Your daytime telephone number
• Your mobile telephone number (if you have one)
• Your email address (if you have one)
• Your signature and the date

How to fill out Form I-693 (For the Civil Surgeon)

As a USCIS certified civil surgeon you are required to report true and accurate results from your examination.

To do this you will need to take down the information from the Applicant’s government-issued identification. You will also be responsible for witnessing that the Applicant fills out and signs Part 2.

You will need to follow the most recent Department of Health and Human Services regulations and the Centers for Disease Control and Prevention guidelines. Those guidelines can be found here.

You may also be asked to make referrals and file case reports. These processes can also be found in the CDC guidelines.

When filling out the I-693 you will need to:

• Verify the Applicant’s Identification Information
• Give a summary of the medical examination, after the exam and any follow-ups necessary are completed
• Give your contact information and sign the form after the examination is complete, certifying that you are a legal civil surgeon. (If you are performing the assessment for a refugee adjustment applicant you will need to include the licensed physician that was present during the examination and the official stamp or raised seal of the health department. If you are a military physician performing the examination for a member or veteran of the U.S. Armed Forces or Coast Guard or certain eligible dependents, the licensed military physician’s signature – who is operating under the blanket civil surgeon – is required as well as the official stamp or raised seal of the military treatment facility.)
• Fill out the worksheet included in the I-693
• Include the results of any lab work or other studies that were required to determine whether the Applicant is inadmissible to the U.S. on health-related issue
• If a referral is required, fill out Item 5 in the worksheet found in Part 7. The physician referred will then need to fill out Part 8. (If a referral is not necessary, leave Item 5 in the worksheet blank.)

Is there a filing fee?

There is no filing fee for the I-693.

How to file the I-693

• Make an appointment with a civil surgeon certified by USCIS.
• Fill out Part 1. In your I-693. (Do not sign it yet. You must sign the form in front of the civil surgeon.)
• Keep your appointment with the civil surgeon. If more visits are necessary, attend all of those as well. Make sure to bring proof of your identity and any medical records you may have with you to your appointment. For proof of identity bring a valid government-issued photo identification (i.e. valid passport or driver’s license). If you are under 14 documents must show your name, place of birth, parents’ full names, and any other information that can identify you (i.e. birth certificates or affidavits, include translations when necessary).
• The civil surgeon should complete the I-693, witness you signing it, and make a copy. The civil surgeon should seal the original I-693 in an envelope and give it to you to submit to USCIS and give you the copy they made.
• You should then submit the sealed letter to USCIS. If you are filing the I-693 because you are applying for and adjustment of status you may do this in one of three ways:
• Mail it with your Form I-485 to the address that matches your reason for filing the I-485. A list of reasons for filing the I-485 and the address needed can be found here.
• Mail the I-693 after you’ve mailed the I-485 to the address specified in your latest communication with USCIS.
• Submit the I-693 in person when you go in for an interview at a USCIS field office.

If you are not applying for an adjustment of status, follow the instructions given by the office requesting the medical examination.

Ways to fill out the Form I-693