After completion of the medical examination, the civil surgeon is required to give you, the applicant, the completed Form I-693 in a sealed envelope. Do not accept it if it is not in a sealed envelope. USCIS will return the form to you if it is not in an envelope or if the envelope has been opened or altered.
You, the applicant, not the civil surgeon, are required to submit the Form I-693 to USCIS.
If you are applying for adjustment of status: Submit Form I-693 together with your Form I-485, Application to Register for Permanent Residence or Adjust Status, as detailed in the instructions to Form I-485.
Other applicants: Follow the instructions on or included with the application for or the instructions given to you by the office requesting the medical examination.
Editions: The current edition is the edition dated 02/25/2010.
Use of earlier editions:
For medical examinations conducted on or after January 1, 2010, the results of the medical examinations may be recorded on either the October 14, 2009, or the February 25, 2010 edition of Form I-693. No edition earlier than the October 14, 2009, edition may be used.
The October 14, 2009, edition is also acceptable for medical examinations completed before January 1, 2010, that used the Interferon Gamma Release Assay (IGRA) test for tuberculosis screening.
The edition dated June 5, 2008, will be accepted for medical assessments conducted prior to January 1, 2010, that utilized the Tuberculin Skin Screening Test (TST).
Special Instructions for the Applicant:
The medical examination must be conducted by a physician who has been designated by USCIS as a civil surgeon. A current list of civil surgeons in your area is available at the Civil Surgeon Locator, at USCIS.gov.
You may also obtain the names and phone numbers of the designated civil surgeons in your area by calling USCIS' National Customer Service Center at 1-800-375-5283. You will be asked to provide your zip code. Please have a pen or pencil ready to write down the list of civil surgeons in your area.
The civil surgeon is required to complete the medical examination according to the Technical Instructions for the Medical Examination of Aliens in the United States, written by the Centers for Disease Control and Prevention (CDC). It is your responsibility to attend your medical exam appointment and all follow up exams and testing, as may be required by the civil surgeon. Failure to comply with the civil surgeon's instructions may lead to the civil surgeon's inability to complete the medical exam, as directed by CDC and USCIS.
To view the Technical Instructions for the Medical Examination of Aliens including the TB and Vaccination Component of the Technical Instructions, please visit CDC's website (www.cdc.gov/immigrantrefugeehealth/exams/ti/index.html).
After the medical examination is completed, the civil surgeon must give you the original and completed Form I-693 in a sealed envelope. Do not open the envelope.
The civil surgeon must also give you a copy of the completed and signed Form I-693 and any supporting documentation submitted to USCIS to you for your records.
Special Instructions for Civil Surgeons:
In order to perform medical examination of aliens, you must be a physician designated by the United States Citizenship and Immigration Services (USCIS) as a Civil Surgeon. If you are not designated, you should seek designation from the USCIS District Office within your jurisdiction. For more information, please visit Designated Civil Surgeons on USCIS.gov.
The medical examination of aliens in the United States must be performed according to CDC's Technical Instructions for the Medical Examination of Aliens in the United States (Technical Instructions or TIs), published by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. These Technical Instructions include the following documents:
The Technical Instructions for Medical Examination of Aliens in The United States (1991)
The Tuberculosis Component of Technical Instructions for the Medical Examination of Aliens in the United States (May 2008)
Adjustment of Status for U.S. Permanent Residence Requirements: Technical Instructions for Vaccinations 2009
Any updates to the documents above as published on CDC's website.
These documents and updates can be obtained from CDC's website.
CDC does not mail hard copies of these documents; it is the responsibility of the civil surgeon to obtain these documents on-line and to comply with the requirements of the Technical Instructions.
Failure to comply with the Technical Instructions may result in the revocation of civil surgeon designation by USCIS.
Updates:
Reminder: For medical examinations conducted on or after January 1, 2010, the results of the medical examinations must be recorded on the October 14, 2009 or the February 25, 2010 edition of Form I-693. Any previous editions of Form I-693 that are used for purposes of the medical examination on or after January 1, 2010 are not acceptable.
The February 25, 2010 edition of the Form I-693 reflects that an individual should no longer be tested for HIV infection, and that individuals do not have to be vaccinated with the herpes zoster (zoster) and Human Papillomavirus (HPV) vaccine. Any reference to HIV, HPV or zoster has been removed in the February 25, 2010 edition. If a physician is using the October 14, 2009 edition of Form I-693, the physician should:
Write "No longer required" in the entry for HIV testing, and for HPV or zoster (if applicable); or
Leave these entries blank.
For more information please see the "Civil Surgeon Letter: HIV and Vaccination Update" link to the right.
Note: The results of the medical examination are generally valid for only 12 months. Applicants should schedule the medical examination as close as possible to the time they file for adjustment of status, but provide for sufficient time for the performance of laboratory testing or additional testing required under CDC's Technical Instructions.
This page can be found at http://www.uscis.gov/i-693
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