This article explains how to prepare for the medical exam and submit the Form I-693.
Green Card Application
Updated: December 5, 2024
Every immigrant that applies for a Green Card must first complete a medical examination with a USCIS certified doctor.
This article explains everything you need to know about the medical exam and it's associated form, Form I-693, Report of Medical Examination and Vaccination Record.

Immigration medical exams need to be performed by USCIS-authorized doctors. USCIS refers to these doctors as Civil Surgeons and allows them to perform the medical examination required for the Green Card application process.
To find an approved civil surgeon near you, visit myUSCIS Find a Doctor or call the USCIS Contact Center at 800-375-5283.
If you're filing from outside the United States, the medical exam must be completed by a Panel Physician. Panel physicians are different from civil surgeons.
To find more information about the approved panel physician near you, visit Department of State Medical Examination site.
The cost of the medical exam is set by the physician and can vary between providers. Typically the exam is between $100 - $500. You can shop around by calling different providers in your area to find the best price.
During the exam, the doctor will perform a basic physical, ask several questions about your health, and run various tests. After the exam the doctor will fill out and seal the Form I-693 and supporting documents in an envelope for you.
IMPORTANT: Do not open this envelope. USCIS will not accept your medical form if it is not in a sealed envelope or if the envelope is altered in any way.
While USCIS previously allowed Form I-485 to be submitted without a complete Form I-693, Report of Immigration Medical Examination and Vaccination Record, they changed that rule as of December 2, 2024, and now require that adjustment of status applicants submit the medical exam at the time of submission of Form I-485.
For applicants who are required to submit Form I-693, USCIS will reject Form I-485 if the completed medical exam is not submitted concurrently with Form I-485, Application to Register Permanent Residence or Adjust Status.
Effective April 4, 2024 any Form I-693 that was properly completed and signed by a civil surgeon on or after November 1, 2023, does not expire and can be used indefinitely as evidence to show that the applicant is not inadmissible on health-related grounds. USCIS officers have the discretion to request more evidence or a new or updated Form I-693 if they have reason to believe the applicant’s medical condition has changed since the civil surgeon signed the Form I-693, or that the Form I-693 submitted does not accurately reflect the applicant’s medical condition and the applicant may be inadmissible on health-related grounds. Medical exams completed before November 1, 2023, have a 2-year validity period.
You are not required to have another exam if you already had one prior to admission. However, the Form I-485 (green card form) must be submitted within one year of an overseas medical examination.
If a new medical examination is not required, you must still show proof that you meet the vaccination requirements. If the vaccination record (DS 3025) was not included in the original overseas medical examination, you will need a new medical exam.
If you need help or have questions about the medical exam or the Form I-693, please reach to our team and we'll get back to you shortly.
Here are some FAQ's about the green card application process!
Frequently Asked Questions
The immigration process can be overwhelming and the information about marriage based green cards can be complex. Here are some common questions that people have before they get started.
Here is a list of the documents the Applicant/Immigrant should provide as part of the green card application. Keep in mind that the employment/tax documents are only required if the applicant's income will be supporting the petitioner/sponsor's income.
These are the documents you should provide as evidence of a "good faith" marriage:
These are the documents that the Petitioner/Sponsor/U.S. Citizen should provide:
The timeline for green card applications is always changing. You can check this website to find the average processing times of specific applications and the various USCIS service centers. You know which field office is processing an application by the first three letters of the receipt.
On average, we are currently seeing the following timelines:
Employment Authorization Document (EAD) is granted for people in the C09 category (pending I-485) when the I-765 is processed. This gives them work authorization for the time period listed on the EAD, usually one year. Because green card applications are typically taking longer than that these days people may need to apply to renew this document to continue to work while waiting for their green card. The USCIS usually processes this application at a separate field location than the rest of the application.
Optional Practical Training (OPT) is work authorization given to F-1 visa holders to be able to work in their field of study either during their schooling or afterwards. Usually OPT is good for 12 months. Income from OPT is considered temporary as you only have authorization for a short time and usually cannot be counted on the I-864, however if the expiration is not for another year or so and the applicant would likely get their EAD within that time it can be included.
You can use either your married name or your maiden name. Whichever you would rather have on your green card. Often customers keep the maiden name until they get citizenship so their passport, birth certificate, etc match the green card. If you do have documents that don’t match, you will just need to carry your marriage certificate with you. Let us know if you have any other questions or concerns about this.
Starting 12/2/2024, USCIS now requires that any I-485 applicants required to file Form I-693, Report of Immigration Medical Examination and Vaccination Record MUST submit Form I-693 concurrently with their Form I-485. Failing to file the two forms together can result in Form I-485 being rejected.
Once you have a travel permit, you can use that to travel outside the U.S. Before you have it, YOU CAN NOT travel. Otherwise your I-485 will be canceled, unless you have a valid H-1B Visa or L-1 Visa.
To avoid getting into any issues,You need to get authorization prior to travel. Advance Parole generally takes 6-12 months to receive. It is possible to have your I-131 expedited if you have an emergency that requires you to travel outside of the U.S.
“Public charge” is described as someone who is likely to become dependent on government assistance.
Frequently Asked Questions
Updated: Feb. 24, 2020
Public Charge Final Rule goes into effect Feb. 24, 2020.
USCIS will reject any affected application or petition that does not include Form I-944 received on or after Feb. 24, 2020.
Important: SimpleCitizen application packages will include Form I-944 after Feb. 24, 2020. If you have questions about Public Charge or your application, please contact SimpleCitizen support.
“Public charge” is described as someone who is likely to become dependent on government assistance. USCIS has always considered “public charge” when determining your status in the U.S. However, under the current Trump administration the public charge rules will be looked at in a different light.
USCIS wants to know how much government assistance you have received in the past and how much assistance you will likely receive. They’ll use the information you provide to determine whether you will be considered a “public charge” to the government in the future. USCIS gathers this information with the Form I-944, Declaration of Self-Sufficiency.
If you are filing an application to register permanent residence or you are submitting an adjustment of status within the United States and you are completing Form I-485 you’ll need to fill out and include the new Public Charge Form I-944. They’ll look at factors such as the applicant’s age, health, family information, assets, financial status, education and skills, etc. The Form I-944 is automatically included with every SimpleCitizen application package.
In the end they will look at the overall factors you provide to determine if an applicant would become a public charge to the USCIS.
Need help or have questions about public charge? Feel free to reach out to our support team and we'll be happy to help with your application.
Included is a list of the documents that should be provided as part of the green card application
Green Card Application
Here is a list of the documents the Applicant/Immigrant should provide as part of the green card application. Keep in mind that the employment/tax documents are only required if the applicant's income will be supporting the petitioner/sponsor's income.
These are the documents you should provide as evidence of a "good faith" marriage:
These are the documents that the Petitioner/Sponsor/U.S. Citizen should provide:
If you have any questions, feel free to chat with our support team by clicking on the chat icon on the lower left side of the screen.
Helpful links:
How to apply for a green card with SimpleCitizen
Green Card Eligibility Quiz
This article will explain how to find out if you are eligible to apply with SimpleCitizen.
Getting Started
Before you start working on your application, it is important that you find out if you are eligible to apply. The easiest way to determine your eligibility is to use our Eligibility Quiz. It will ask you a few basic questions and help you find the right application for your situation.
Watch this quick video to learn how to use the immigration eligibility quiz:
As always, if you have questions about your situation, feel free to chat with our support team by clicking on the chat icon at the lower left side of the screen. Or, you can schedule a consultation with an immigration attorney here.
What is an EAD or OPT?
General Immigration Information
Last Updated: January 15, 2020.
Employment Authorization Document (EAD) is granted for people in the C09 category (pending I-485) when the I-765 is processed. This gives them work authorization for the time on the EAD, usually one year. Because green card applications are taking longer than that these days people may need to apply to renew this document to continue to work while waiting for their green card. The USCIS usually processes this application at a separate field location than the rest of the application.
Optional Practical Training (OPT) is work authorization given to F-1 visa holders to be able to work in their field of study either during their schooling or afterwards. Usually OPT is good for 12 months. Income from OPT is considered temporary as you only have authorization for a short time and usually cannot be counted on the I-864, however if the expiration is not for another year or so and the applicant would get their EAD within that time it can be included.
Understanding the steps following the submission of a green card application.
Green Card Application
Updated: December 11, 2025
Once you've mailed your application, it can take 2-4 weeks until the USCIS accepts your application and sends the receipt letters to you.
If you sent the USCIS your payment forms, then you can check your bank account to see if those payments have been withdrawn. If so, then that means that the USCIS has started processing your application and will be mailing Forms I-797C, Notice of Action.
These I-797C letters will include your receipt numbers. The receipt numbers are in the upper left-hand corner, next to the date. When the receipt letters arrive, make sure to add them to your SimpleCitizen account under step 5. With these numbers, we can keep you up to date on the status of your case. Keep in mind this will help you avoid delays and roadblocks. Here are a few next steps in your application process:
The first step after getting your Forms I-797C, Notice of Action is the biometrics exam. The USCIS will send you a letter with the time and location of the appointment. Arrive early and bring a copy of your passport and the appointment letter from the USCIS. The USCIS will take your photo and fingerprints as part of the background check for the application process.
If you are unable to make your biometrics appointment, please call the USCIS asap to get it rescheduled. Missing the biometrics appointment can cause serious delays.
The next step in the application process will be getting your EAD ( Employment Authorization Document) and AP (Advanced Parole/travel authorization) approvals. The USCIS is currently taking 6-8 months to process and approve the combo card.
While Advanced Parole can be issued at the same time as Travel Authorization, we are typically seeing it be issued a few months later. Advanced Parole approval is what grants applicants permission to leave the United States temporarily while their Green Card application is pending. This step only applies to applicants who submitted Form I-131 with their green card application. However, please note that travel should still be done with caution as reentry is permitted but not guaranteed. The USCIS is currently taking 8-12 months to process and approve applications to travel.
The next step is having your interview scheduled. It can take a long time for the USCIS to get around to finally scheduling your interview. Based on your local USCIS processing and wait times, we estimate your interview to happen about 10 - 20 months after your biometrics.
Requests for evidence can be granted at any time during the application process. They mean that the USCIS is requesting more information in order to make a decision on the application. RFEs are normal, and if responded to quickly and correctly, typically do not pose a serious risk for the case. However, failing to respond to the request properly or on time can result in the denial of the application. If you get a Request for Evidence, please notify SimpleCitizen here.
If your application and interview are approved, you will receive your Green Card in the mail approximately 12 to 24 months after you initially filed.
Here’s a breakdown of the processing times for each step:
You receive your application receipt from the USCIS
If you prepared and submitted your application correctly, the USCIS will typically respond 2 to 3 weeks later with a letter in the mail. This receipt letter is called the Form I-797C, Notice of Action.
Save this letter! You need the receipt number to check your USCIS status.
Have your receipt? Check your status here.
You receive your appointment notice for biometrics
Typically 3 to 5 weeks after filing, you will receive a notice for your biometrics appointment. This will include your appointment date, time, and location. Most of the time, the location will be the closest USCIS office.
Do not miss your appointment!
Go To Your Biometrics Appointment
During your biometrics appointment, the USCIS will check your fingerprints, take your photo, and ask for your signature. This appointment is usually pretty short and lasts approximately 30 minutes.
Bring these items to your biometrics appointment:
* Your Passport or photo identification issued by your country
* Your Driver's License
* Military Photo Identification (if you have it)
* State issued Photo Identification Card
You receive your EAD Card (if you filed for it)
If you included the form I-765, application for employment authorization, you should expect for it to be approved within approximately 6-8 months. If you receive this card, it means the USCIS considers you an adjustment of status applicant who may work in the United States.
If you included Form I-131, Application for Travel Documents, Parole Documents, and Arrival/Departure Records with your green card application, you should expect for it to be approved within approximately 10-12 months. If you receive this approval, USCIS has granted you permission to leave the United States temporarily. However, travel should be done with caution and the document permits reentry to the United States but doesn't guarantee it.
You receive your notice for your USCIS interview
It's time to prepare for your interview! Don't worry or be scared, the interview is a normal part of the application process and typically happens at your nearest USCIS office. The USCIS may require your petitioner to attend with you, or they may not. Your interview notice will arrive by mail via the Form I-797, Notice of Action.
Do not miss your interview!
Go to your USCIS interview!
Adjustment of status interviews usually take around 30 minutes at your nearest USCIS office. It's a good idea to properly prepare, make sure to bring the following items:
* A complete copy of your entire application.
* Originals of any documents that you sent along with your application.
* Advance parole document and/or employment authorization card (if you have one)
* Your passport
You receive your Green Card!
What do the first three letters of the I-797 notice receipt indicate?
General Immigration Information
Below we have included information defining what the 3-letter USCIS codes mean:
This article will explain step by step how to use SimpleCitizen to prepare your application.
Getting Started
Updated: February 2023
Welcome to SimpleCitizen! We’re happy you’re here! We’ve been making it easy to get a green card, renew a green card, apply for citizenship, and more since our launch in 2015. Today, we’re rated the #1 Online Green Card service.
To learn more about our track record, here are a few links:
• Our certified customer reviews – Trustpilot
• Rated #1 2018, 2019, & 2020 Online Green Card Service – Top Consumer Reviews
• The Business that Love Built – Fast Company Magazine
• Featured by the American Bar Association – 2019
The following article is designed to help you better understand what it is that SimpleCitizen offers and how it works. We’ve broken this article into steps. If you have any questions about our services or our offerings, please feel free to reach out to our Live Chat support line. If you are messaging after business hours, please feel free to leave a message and we will get back to you as soon as we are available.
In order to make sure you are eligible to apply and that you choose the correct application for your situation, we have created a free eligibility tool. With just a few easy clicks it will use the information you provide to help guide you to the correct signup page for the application that you are looking for. After you select your application package and your payment tier, you will be emailed a link to help you log into your new Simplecitizen account.
Please note that if you have a preexisting SimpleCitizen account, you will not be able to sign up for a new account using the same email. For assistance, please reach out to our live chat support team.
If you have questions during the eligibility quiz, please feel free to chat with SimpleCitizen support by clicking on the chat icon at the bottom left side of the screen.
After you login to your SimpleCitizen account for the first time you will see the Welcome Page. This page acts as a landing page with the tips and tricks designed to help you be successful as you navigate filling out the questionnaire and documentation upload sections. Please pay close attention to these as they will guide you through completing everything in the questionnaire as quickly and as smoothly as possible.
After you review the information and resources on the Welcome page you will then want to begin the questionnaire. To get started on your application, click on the “Start Here” button (as pictured below). The questionnaire will help guide you through all the information on the USCIS form(s) associated with your application. It will use your answers to help you select the correct forms. If your application has optional forms (such as work authorization or travel authorization) we will give you the ability to choose if those are forms you would like to submit to USCIS.
The questionnaire has multiple sections – please ensure you go through all of them before moving on.
The questionnaire is full of information text and links to help make USCIS questions as clear as possible so you don’t have to guess. There are multiple steps and each step must be completed prior to continuing to the next step.
If you have questions as you fill out the information we have a chat feature where you can reach out for help and guidance.

Once you have completed all sections of the questionnaire, you will then be able to access the Document Upload section. The document upload is where you will upload all the required supporting documents for your application. These uploads are determined by how you answer questions in the questionnaire.

Click on the orange upload buttons to upload each document. As you are uploading files the system will allow you to upload multiple files under a single upload.
Supported file types include: JPG, PNG, & PDF, however PDF uploads are the most clear. If you would like to convert your documents to PDF there are free services such as the Adobe PDF converter that can be used to do so, Adobe also has a PDF Merger that you can use to combine multiple documents into a single file. This is helpful especially for files that you want in specific orders, such as chronologically ordered pay stubs or tax documents. If you do not have a scanner for your documents, you can login to your account on a smart phone and take pictures of your documents with a camera phone.
Translations of USCIS required documents: When uploading a required USCIS document, please indicate the “Document Language” by choosing from the drop down. This will let SimpleCitizen know that the document needs to be translated by a USCIS certified translator. We provide translation services at no extra cost for those required documents.

If you have questions or need help with your supporting documents, please reach out to our live chat support team.
With SimpleCitizen, all applications receive the benefit of having your entire application reviewed by an immigration attorney from our network attorney. This review will ensure that there are no mistakes or missing paperwork in your application. They will complete their review of your application within 5-10 business days and you will then be assigned a case support team who will communicate the attorney feedback to you.
Once you receive the feedback, you should go into your questionnaire and make the requested changes. If you have any questions regarding the feedback or how to implement those changes you can reach out to your case support team and they will guide you. After you have implemented all of the requested updates to your questionnaire, please let your case support team know that you are finished.
Reminder: SimpleCitizen partners with an independent network of immigration attorneys for the review of your application, but we are self-service. Applicants are able to choose how to implement suggestions received from the attorney, but if an RFE (request for evidence) is received from USCIS or your application is denied due to a decision to not follow our network attorney’s suggestions or to alter the application following their reviews, your purchase is not covered by the SimpleCitizen Satisfaction Guarantee.
After you notify your case support team that you have implemented the requested changes, they will check the updates and verify if all changes are made in accordance with the attorney’s recommendations. This typically takes 1-3 business days. In order to help this process go more quickly, please take extra care to ensure that all recommendations have been implemented before moving on so that the case support team can approve the application for finalization.
Once your case support team has confirmed that all of your changes have been implemented correctly, they will send you a PDF draft of your application for you to review. Please review it carefully and keep detailed notes as you go. Your case support team can then help you make any last-minute changes.
Pro Tip: If, during your review, you notice that some of the information is incorrect, take a look at your questionnaire and make sure it has been entered correctly.
Once the reviews are complete, our team at SimpleCitizen will print and ship the application to you. You should also send a confirmation to your case support team with your preferred mailing information. The shipping team will take 1-2 business days to prepare your application for mailing. You will then receive a tracking number so you can track the package.
The application will be sent to your mailing address and will include detailed USCIS filing instructions so you’ll know exactly what you need to do and how to do it. It’s really simple- All you have to do when you get the application is sign the forms (we attach stickers so you know who needs to sign where), attach payment, and passport style photos (if required). We also include a pre-addressed USCIS shipping envelope for you to insert the signed application and take it to your preferred courier service for mailing.
As always, if you ever need any help, please reach out to our support team. We’re here to help!
The best place to start is our free eligibility tool. It will help guide you to decide which package is best for you.
If you have questions during the eligibility quiz, feel free to chat with SimpleCitizen support by clicking on the chat icon at the bottom left side of the screen. After you select your application package, you will be emailed a link to your new account.
A list of some of the general documents required for green card applications.
Green Card Application
Here is a list of some of the general documents the Applicant/Immigrant should provide as part of the green card application. Keep in mind that the employment/tax documents are only required if the applicant's income will be supporting the petitioner/sponsor's income.
These are the documents you should provide as evidence of a "good faith" marriage:
These are the documents that the Petitioner/Sponsor/U.S. Citizen should provide:
Click here to learn how to upload your documents to your SimpleCitizen account and prepare your Green Card application.
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