The immigration medical exam is one of the steps that raises the most questions when applying for a green card. The rules changed several times between 2023 and 2025, and much of what is online no longer applies. At Clínica Hispana Corazón y Vida in Pasadena we do the exam in Spanish; here is how it works today according to USCIS.
What is Form I-693 and who signs it?
Form I-693 is the medical report USCIS uses to confirm that an applicant has no health conditions that would make them inadmissible. Only a physician designated by USCIS as a Civil Surgeon can sign it; a doctor without that designation cannot complete it, even if they are your regular doctor. Before booking, confirm the clinic appears in the official USCIS Civil Surgeon locator.
What happens during the visit in Pasadena?
The visit takes one to two hours and has four parts:
- Document and history review. Photo ID, vaccination record and any previous medical reports.
- Physical exam. A general check of eyes, ears, throat, heart, lungs, abdomen and skin, plus questions about mental health and substance use.
- Lab tests. A blood test for tuberculosis (IGRA) from age two; a syphilis test between ages 18 and 44; a gonorrhea test between ages 18 and 24. If the tuberculosis test is positive, a chest X-ray is required before the form can be completed.
- Vaccines. We review the ones you already have and give the ones missing for your age.
Which vaccines does USCIS require in 2025?
Under the current CDC Technical Instructions, the Civil Surgeon reviews, according to the applicant's age: measles, mumps and rubella (MMR) for people born in 1957 or later; tetanus, diphtheria and pertussis (Tdap or Td); polio; hepatitis A and B; varicella; influenza during flu season; pneumococcal and meningococcal at the indicated ages; and rotavirus and Hib for infants. The COVID-19 vaccine is no longer required: USCIS announced on January 20, 2025 that it would not deny applications for lacking it, and the CDC removed it from its instructions on March 11, 2025.
If you already have any dose, bring written proof. Without a record, the vaccine counts as not given.
How is the I-693 submitted?
The Civil Surgeon gives you the completed form in a sealed envelope plus a copy for your records.
- Paper filing: submit the envelope sealed together with Form I-485.
- Online filing: USCIS instructs you to open the envelope and upload the scanned form.
- If the envelope was opened by mistake: there is no need to repeat the exam; USCIS accepts the opened original.
Since December 2, 2024, the I-693 must be filed together with Form I-485. If you send it separately, USCIS may reject the green card application. That is why it is best to take the exam when your attorney has the package nearly ready.
How long is it valid?
Since June 11, 2025, USCIS generally treats the I-693 as valid only for the application it is submitted with; it no longer has a fixed expiration date. Forms signed before November 1, 2023 keep the two-year validity they had. In addition, since July 3, 2025 USCIS only accepts the 01/20/25 edition of the form; check the date at the bottom of each page.
What should I bring?
- Passport or photo ID.
- Vaccination record, even if it is in another language.
- Medical reports for chronic conditions, if you have them.
- A list of your medications.
- Your name exactly as it appears on your immigration application.
What can delay the process?
Missing vaccine records, a positive tuberculosis test that requires waiting for the X-ray, or an incomplete form. None of these closes the door: for several medical conditions a waiver exists that your attorney can request.
How much does it cost?
The exam is self-pay, no insurance needed, in cash or by card. Any vaccines and tests you need are charged according to your case. Call (832) 930-5551 or message us on WhatsApp at (346) 646-2974 to confirm the price before you come.
Schedule your immigration medical exam in Pasadena or walk in at 918 W Southmore Ave, Suite 180, every day from 9 AM to 9 PM.
Official sources: USCIS: Form I-693 · Policy Manual, Vol. 8, Part B, Ch. 4 · Policy Manual, Vol. 8, Part B, Ch. 9
This article is informational and does not replace advice from an immigration attorney.
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