1. Form I-693, Report of Medical Examination and Vaccination Record Texas Service Center October 2010

2. 2 What is the Purpose? Report results of a medical examination. Establish that an applicant for adjustment of status is not inadmissible to the United States on public health grounds.

3. 3 Who Files Form I-693? Generally, all applicants filing for adjustment of status to that of a lawful permanent resident (Form I-485).

4. 4 Are There Any Exceptions? While a new medical examination may not be required for the following groups, compliance with vaccinations may still be required and certain sections of Form I- 693 must still be completed. Refugees; Derivative asylees who took an overseas medical examination; K nonimmigrants; and V nonimmigrants. *These individuals may need to undergo a new medical examination in certain cases.

5. 5 What are the Medical Grounds of Inadmissibility? Communicable diseases of public health significance; Lack of required vaccinations; Physical or mental disorders with harmful behavior; and Drug abuse or addition.

6. 6 What are Class A and B Medical Conditions? Class A medical conditions render an applicant inadmissible to the U.S. Class B medical conditions do not constitute a ground of medical inadmissibility and are defined as physical or mental abnormalities, diseases, or disabilities serious in degree or permanent in nature amounting to a substantial departure from normal well-being.

7. 7 Which Vaccinations are Required? Mumps, measles, rubella Polio Tetanus and diphtheria toxoids Pertussis Haemophilius influenza type B Hepatitis B The following additional vaccines are required for immigration purposes on or after December 14, 2009: Varicella Influenza Pneumococcal Rotavirus Hepatitis A Meningococcal

8. 8 Is a Fee Required? USCIS does not charge an individual any fee to file Form I-693. Designated civil surgeons or health care facilities charge individuals for the medical examination and any follow-up tests or treatments.

9. 9 Who Conducts Medical Examinations for USCIS? Designated civil surgeons. Can be found via Civil Surgeon Locator, USCIS National Customer Service Center (NCSC), or local USCIS office. For refugees, state or local health departments.

10. 10 New Fee Rule Effective November 23, 2010, certain physicians seeking civil surgeon designation must pay an $615 application fee. New 8 C.F.R. section 103.7(b)(1)(i)(SS). No effect on currently designated civil surgeons.

11. 11 Which Form Version Does a Civil Surgeon Use? Current edition date: July 20, 2010. For medical examinations conducted on or after July 22, 2010, 2010, the results of the medical examinations may be recorded on either the February 25, 2010 or July 20, 2010 edition.

12. 12 What Actions Does a Civil Surgeon Take? Civil surgeons complete a variety of tasks, such as verifying identity; Reviewing medical records; adhering to U.S. Department of Health and Human Services regulations and guidelines; referring individuals and making reports; properly completing Form I-693 and placing it in a sealed envelope; and retaining a copy of Form I-693 and giving a second copy to the individual.

13. 13 Where Does an Individual File Form I-693? Applicants for adjustment of status submit Form I-693 together with Form I- 485. Other applicants follow the specific instructions included on the form or given by USCIS.

14. 14 How Long is Form I-693 Valid? Form I-693 is normally valid for a period of one year from the date it was signed by the civil surgeon. Based on an agreement with the Centers for Disease Control (CDC), the validity of Form I-693 is extended until January 1, 2011 provided that certain conditions are met.

15. 15 To When is the Validity Extended? Required conditions to extend the validity of Form I-693: Form I-693 was included with the initial filing of Form I-485; and There is no Class A or B medical condition noted in section 2, 3 or 4 of Part 2 of Form I-693. This policy is in effect until January 1, 2011 and valid for any case that is adjudicated on or before January 1, 2011.

16. 16 USCIS Review of Form I-693 Immigration Service Officers (ISOs) review Form I-693 for the following: proper completion by a designated civil surgeon; original signatures; the results of any required tests and required referrals; the vaccination record; and whether any waivers are required and available.

17. 17 Are Waivers Available? Depending on the inadmissibility, some discretionary waivers are available for certain applicants. Some waivers do not require any action from the applicant. Different guidelines apply to refugees and asylees seeking adjustment of status.