If you’ve received your USCIS green card interview or adjustment-of-status notice, you’ve also received a deadline that often surprises applicants: the I-693 medical examination must be completed by a USCIS-designated civil surgeon and submitted with your application. With recent USCIS policy changes effective in 2025 and continuing through 2026, the rules around timing, vaccination requirements, and submission format have evolved — and getting the exam wrong is one of the most common reasons applications get delayed or returned.

At Medi-Station Urgent Care, our team is led by board-certified emergency physician Dr. Carlos Sanchez and includes designated USCIS civil surgeons authorized to perform the I-693. This guide walks Miami Shores and North Miami Beach immigration applicants through the entire process in 2026.

Who Needs an Immigration Medical Exam

The I-693 is required for most applicants seeking adjustment of status to lawful permanent resident (green card) inside the United States. According to USCIS official guidance, this includes:

• Applicants filing Form I-485 (Application to Register Permanent Residence or Adjust Status)
• Certain refugee, asylee, and humanitarian parolee adjustments
• TPS-to-green-card transitions in some cases
• Family-based green card applicants

Applicants going through consular processing abroad have a parallel exam process (DS-2054) performed by panel physicians overseas. The I-693 is specifically for the in-country adjustment pathway.

The Big 2025/2026 Change: I-693 Validity Updates

USCIS made a significant policy update affecting validity timelines in 2024 that continues to apply through 2026. Key updates applicants need to know:

• Civil surgeon signature dates matter. The exam must be signed by the civil surgeon within USCIS’s defined timeframe relative to your filing or interview.
• Submission with I-485 is now preferred. USCIS strongly encourages submitting the completed I-693 with your initial I-485 filing rather than at the interview, to avoid request-for-evidence (RFE) delays.
• Sealed envelope delivery is the standard. The civil surgeon must place the completed exam in a sealed envelope; the applicant submits it unopened with their application.

These rules sound simple. In practice, an exam done by a non-designated provider, or done too early relative to your filing window, can be rejected — costing months of additional processing time.

What the I-693 Exam Actually Covers

A complete I-693 has several components, all performed during the same visit at our clinical urgent care center:

1. Medical history review. Past illnesses, surgeries, mental health history, substance use, and current medications.

2. Physical examination. Head, eyes, ears, nose, throat, cardiovascular, pulmonary, abdominal, neurological, and dermatologic examination.

3. Communicable disease screening. Tuberculosis screening (typically IGRA blood test, or chest X-ray if indicated), syphilis screening, gonorrhea screening, and Hansen’s disease (leprosy) screening for applicants where indicated.

4. Mental health and substance use assessment. Standardized screening for conditions that would render an applicant inadmissible under public-health grounds.

5. Vaccination requirements. A specific list of vaccines must be either completed, documented, or medically waived. For 2026, the USCIS-required vaccinations include: MMR, Tdap, polio (for applicants under 18), varicella, influenza (seasonal), pneumococcal (when indicated), meningococcal, hepatitis A, hepatitis B, rotavirus (for infants), Hib (for infants), and COVID-19 (per current CDC guidance).

The CDC Technical Instructions for Civil Surgeons governs the medical and vaccination protocols and is updated periodically. Our team tracks every update.

What to Bring to Your Appointment

To make sure your visit produces a usable I-693 in a single appointment, bring:

• Government-issued photo ID (passport preferred)
• Your I-485 case receipt or USCIS notice if you have one
• All available vaccination records — including childhood records from your home country (translated if not in English)
• Any chest X-ray or TB test results you’ve had in the last 6 months
• A list of current medications and any chronic medical conditions
• Eyeglasses or contact lenses if you wear them

If you bring vaccination records, our civil surgeon can document already-completed vaccines and only administer what’s missing. Without records, you may need full vaccination — adding time and cost.

Timeline: How Long the Process Takes

A typical I-693 exam at Medi-Station Urgent Care runs about 60–90 minutes for the appointment itself. If TB testing is required and a blood draw (IGRA) is used, results come back within 2–4 business days. If chest X-ray is indicated, it’s typically performed the same day at our partner imaging center.

Vaccination completion depends on what you need. Single missing vaccine — one visit. Hepatitis B series — requires three doses over six months (though USCIS does allow submission with the series in progress under certain documented conditions).

Most applicants who bring complete vaccination records can have a fully completed, signed, sealed I-693 within one week of the initial visit.

Common Reasons I-693s Get Rejected by USCIS

We see these issues regularly when applicants come to us after a rejection:

• Exam performed by a non-designated provider (must be a USCIS civil surgeon)
• Vaccination history incomplete or missing required vaccines
• Envelope opened by the applicant before submitting to USCIS
• TB or syphilis screening not properly documented
• Civil surgeon stamp or signature missing
• Form completed in pencil or with white-out
• Outdated form version used (USCIS periodically updates Form I-693)

Working with a designated civil surgeon who does this volume — and tracks USCIS policy changes — eliminates almost all of these failure modes.

Why Medi-Station for Your I-693

A few reasons our immigration patients consistently recommend us:

• USCIS-designated civil surgeons on staff
• Same-week appointments — including walk-ins
• Spanish-speaking team — bilingual front desk and clinical staff
• On-site diagnostics — X-ray and lab work under one roof, no third-party referrals
• Mon-Fri 9am–8pm, Sat-Sun 10am–5pm hours that fit working schedules
• Self-pay flat rates and many insurance plans accepted

Our broader immigration examination services page has additional FAQs and pricing.

What If You’re on a Tight Timeline?

If your USCIS interview is in the next 30–60 days, do not wait. Schedule your I-693 this week. A few extra days at the front end of the timeline absorbs any unexpected lab result delays or follow-up requirements without putting your case at risk.

Schedule your I-693 medical exam at medistationurgentcare.com

Medi-Station Urgent Care — Miami Shores, FL | Mon-Fri 9am–8pm, Sat-Sun 10am–5pm