USCIS Revises Form I-693, Report of Medical Examination and Vaccination Record
USCIS has revised Form I-693, Report of Medical Examination and Vaccination Record (Revision Date 10/14/09/Expiration Date 10/30/11) based on the Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC)'s Update to the Tuberculosis (TB) Component of the Technical Instructions for the Medical Examination of Aliens in the United States (TB Component of the Technical Instructions), effective November 1, 2009. USCIS anticipated the update and revised Form I-693 to bring the form in accordance with this update to the TB Component of the Technical Instructions. The new version of Form I-693 (Edition October 14, 2009) and its filing instructions can be found on our website at www.uscis.gov.
Under the previous version of the Form I-693 (Edition June 5, 2008), a civil surgeon was directed to use the Tuberculin Skin Test (TST) as an initial testing method to determine whether the applicant had cell-mediated immune reactivity to Mycobacterium tuberculosis. With the Update to the TB Component of the Technical Instructions, and under the revised version of the Form I-693, a civil surgeon may now administer an interferon gamma release assay (IGRA) in place of a TST.
Current acceptable IGRAs for the change of status examination are: QuantiFERON® TB Gold, QuantiFERON® TB Gold In Tube, and the T-Spot® TB test. If the CDC adds additional IGRAs, it will post an announcement on its website. A copy of the Update to the TB Component of the Technical Instructions can be accessed on CDC's website at http://www.cdc.gov/ncidod/dq/civil.htm (click on Technical Instructions for TB or Updates).
Civil surgeons may continue to use the June 5, 2008 edition of Form I-693 until January 1, 2010 but only if the civil surgeon uses the TST test as an initial screening method for TB. If an IGRA is used as a means to initially screen for TB infection, the civil surgeon must submit the results of the medical examination on Form I-693 (Edition October 14, 2009). The civil surgeon may not provide the results of the IGRA on Form I-693 (Edition June 5, 2008). Beginning on January 1, 2010, the civil surgeon must use the October 14, 2009 edition of Form I-693 to record the results of the medical exam, irrespective of the TB screening test used.