The U.S. Citizenship and Immigration Services (USCIS) now requires a fresh medical exam for every Green Card application. This rule took effect June 11, 2025. USCIS rescinds any I-693 form when an applicant withdraws or abandons a filing. Each new Green Card petition demands a new exam.
Green Card I-693 Requirement Update
USCIS ended its April 2024 policy that let applicants reuse medical forms indefinitely. Now any withdrawn or expired petition invalidates the I-693, Report of Immigration Medical Examination and Vaccination Record. You must retake the exam for each new Green Card filing.
This rule applies to all I-693 forms signed on or after November 1, 2023. USCIS states this change protects public health by ensuring timely treatment and up-to-date vaccinations.
Impact on Applicants
This update affects every applicant who plans to pause or refile. You lose months if you must rebook an exam; you pay exam fees again. You risk missing filing windows, so plan your Green Card timeline to avoid gaps.
Green Card Exam Process
Follow these steps to meet the new requirement:
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Find a Civil Surgeon
Use the USCIS locator -
Gather Records
Collect past medical tests, vaccination records, passport copy. -
Book Appointment
Schedule six weeks before Form I-485 filing. -
Attend Exam
Surgeons check physical health, blood tests, chest X-ray (if over 15), and vaccinations. -
Receive Sealed I-693
Keep the envelope sealed. -
Submit with Green Card Application
Mail sealed I-693 with Form I-485 to USCIS.
Repeat this sequence for any new petition.
Green Card Cost Breakdown
Plan for these expenses:
| Item | Cost Range (USD) | Notes |
|---|---|---|
| Civil Surgeon Exam | 100–500 | Average $300 per visit |
| Vaccination Updates | 50–200 | Depends on missing shots |
| Travel to Clinic | 20–100 | Varies by city |
| Document Translation | 50–150 | For non-English records |
| I-485 Filing Fees | 1,225 | Includes biometric fee |
Total medical exam budget per filing: $420–$1,000. Add the $1,225 filing fee for Form I-485 separately.
Medical Exam Components
A civil surgeon performs:
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Physical Exam: Checks heart, lungs, sight, and hearing.
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Blood Tests: Screens for communicable diseases like syphilis and tuberculosis.
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Chest X-Ray: Required for applicants over age 15.
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Vaccination Review: Verifies MMR, polio, and other immunizations.
Expect the entire exam to take one hour. Review CDC vaccine schedules to avoid last-minute shots.
Green Card Exam Retake Triggers
You must retake the medical exam if you:
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Withdraw your Green Card application.
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Receive a Request for Evidence (RFE) that invalidates your prior I-693.
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Change visa categories before USCIS approves your permanent residency.
Plan exam dates near your expected filing to reduce risk. Do not schedule more than six months before you file Form I-485.
Green Card Policy Rationale
USCIS cites public health risk in its announcement. Officials note that expired exams left gaps in treatment for conditions like tuberculosis and hepatitis. Fresh exams force up-to-date care. This rule aligns with CDC standards: https://www.cdc.gov/immigrantrefugeehealth/exams/ti/medical-history.html
Implications for Applicants
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Time Management: Book exams close to filing dates.
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Budget Adjustments: Build exam costs into your Green Card plan.
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Document Control: Keep all medical forms in a dedicated folder.
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Legal Standing: Consult an attorney to avoid RFEs or denials.
Civil or criminal issues can trigger ICE action against Green Card holders. Maintain legal compliance.
Next Steps for Candidates
Review Your Filing Timeline
Map key dates for Form I-485, medical exam, and document gathering. Mark deadlines for fee payment and evidence submission. Build in buffer time for delays. Use a calendar app or spreadsheet to track each step.
Secure Your Exam Budget
Set aside at least $500 for each medical exam. Include costs for the civil surgeon, vaccines, lab tests, and travel. Check clinic fee schedules before you book. Keep receipts in a dedicated folder. Monitor exchange rates if you pay in foreign currency.
Book Your Civil Surgeon Early
Find a USCIS-approved civil surgeon
Aim to schedule your exam six weeks before you file Form I-485. Confirm vaccine availability. Ask about additional tests that clinics may require.
Track Policy Updates Daily
Subscribe to USCIS alerts
Follow the U.S. Department of State for panel-physician lists
Sign up for email notifications from AILA
Stay aware of policy shifts that can affect your Green Card filing.
Consult an Immigration Expert
Hire a qualified attorney to review your application. Consider getting in touch with an expert immigration law attorney at Maple Crest Law.
Conclusion
USCIS enforces fresh medical exams for every Green Card petition. You must adjust timelines, budgets, and document plans. Follow this guide to avoid delays. A clear strategy smooths your path to U.S. permanent residence.
Maple Crest Immigration Law
Ready to secure your Green Card with no delays?
Maple Crest Immigration Law offers expert guidance on I-693 requirements and Green Card filings. Our team helps you:
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Plan your medical exam timeline
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Manage filing costs
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Prepare error-free applications
Book a consultation today and take control of your Green Card journey.
Contact Maple Crest Law – Your success starts here!
