How to Fill Out Form I-693

Updated on April 10, 2024

At a Glance

  • Form I-693 is completed by a civil surgeon during a medical examination.
  • Provide personal information in Part 1, including the Alien Registration Number, full names, and date of birth.
  • Sign and certify accurate information in Part 2.
  • Civil surgeon completes Part 5 to confirm identification.

If you apply for immigration benefits in the United States, you will be required to undergo a medical examination. The United States Citizenship and Immigration Services (USCIS) requires this to make sure you aren’t possibly inadmissible to the U.S. on public health grounds (if you’re not sure what these grounds are, you can take a look here).

When you undergo your medical examination, you will use Form I-693 to report the results back to the USCIS.

We know medical exams can be stressful, especially if it’s thrown on top of an immigration journey that is already loaded with paperwork and uncertain outcomes. To make this step a little easier, you can use the Form I-693 instructions we set out for you below. 

Steps to Complete Form I-693

The most substantial parts of Form I-693 will be completed by the civil surgeon conducting your medical examination. There are only small parts you have to complete yourself. 

Here are a few Form I-693 instructions to help you navigate the sections.   

Part 1. Information About You

Part 1 is where you have to provide all your personal information.

The personal information you will have to fill in includes your:

  • Alien registration number
  • Full names
  • Date of birth
  • Physical address
  • Gender
  • USCIS online account number
  • Country of birth.

You have to include your full legal name as it appears on your birth certificate or government-issued identity document. If your name has been legally changed by marriage or court order, for example, you can include your new legal name. 

Remember, your Alien Registration Number and USCIS Online Account Number aren’t the same. You have to include the correct number in the right space. 

Part 2. Applicant’s Statement, Contact Information, Certification, and Signature

In Part 2, you sign and date the form and provide your certification. By signing the form, you certify and declare:

  1. You reviewed and provided all the information in the form
  2. You understood the questions and information, and 
  3. The information you provided is true and accurate. 

You must also indicate if you completed the form yourself or used an interpreter or preparer who completed the Form I-693 on your behalf. 

When you’re done, you can sign and date Part 2 of the form. Don’t forget the civil surgeon must witness you signing your Form I-693. So, don’t sign this part until you are at your medical exam appointment. 

Part 3. Interpreter’s Contact Information, Certification, and Signature

It’s not uncommon for people to use interpreters if they’re not comfortable completing legal forms in English. 

If you used an interpreter, your interpreter must complete Part 3 and provide their contact information. Your interpreter also has to sign and provide their certification. 

By signing Part 3, your interpreter is certifying:

  • They are fluent in English, and the language used to interpret to you
  • They have read every question and instruction on the form, and your answers to each question to you, and
  • You understood each and every instruction, question, and answer to each question.

Part 4. Contact Information, Declaration, and Signature of the Person Preparing this Application, if Other Than the Applicant

If a professional like a lawyer or agency helped you complete your Form I-693, their information must be provided here. If someone acted as your interpreter and your preparer, they must complete both Part 3 and Part 4. If no one assisted you in completing the form, you could write N/A. 

Advice from a friend or things like typing assistance doesn’t count as using a preparer for the purposes of Part 4. You don’t have to provide their details here. A preparer is someone who completed the whole Form I-693 on your behalf. 

Part 5. Applicant’s Identification Information

Part 5 will be completed by the designated civil surgeon. In Part 5, the civil surgeon will confirm the form of identification you used at your appointment and fill in your identity number (if applicable). It is also the civil surgeon’s responsibility to check the top of each page of your Form I-693 and ensure your A-number is correct.  

Part 6. Summary of Overall Findings

In Part 6, the civil surgeon provides a summary of the medical examination. They have to select whether you have any Class A or Class B conditions. You can take a look at what is a Class A or Class B condition here. The civil surgeon will also note the date the exam took place and the date of the follow-up examination if one is required. 

Part 7. Civil Surgeon’s Contact Information, Certification, and Signature

After the medical exam is done, the civil surgeon will complete and sign Part 7. The civil surgeon’s identification information must be provided here. The civil surgeon will only sign and date Part 7 if you are medically cleared. If they refer you to another specialist or require a follow-up, they will only sign this when they are happy with your results. 

By signing the Form I-693, the civil surgeon certifies they have a valid, unrestricted license in the jurisdiction in the United States in which they conducted the medical exam. They also certify that no other jurisdiction has revoked or placed restrictions on their license to practice medicine. 

Part 8. Civil Surgeon Worksheet and Part 10. Vaccination Record

The civil surgeon fills out the worksheet in Part 8 as they do the medical examination. They will check and provide information about infectious diseases that could be significant to public health, physical or mental disorders with associated harmful behavior, drug abuse or drug addiction, and vaccinations. Any results of lab work or studies that had to be conducted will also be provided here. 

Some of the conditions the civil surgeon has to test for include:

  • Tuberculosis (TB)
  • Syphilis
  • Gonorrhea
  • Hansen’s Disease.

If the civil surgeon chooses to refer you to the Health Department or other doctor, the referral doctor’s details will also be provided in Part 8. Item 5 of Part 8 must only be completed if the referral is required. If the referral is only recommended, this part should be left blank. 

In Part 10, the civil surgeon will include a full vaccination record. Any vaccinations you have received in the past will be listed here together with a date. This includes vaccinations for Hepatitis B, Varicella, Pneumococcal, Influenza, Rotavirus, Hepatitis A, and Meningococcal.

Part 9. Referral Evaluation

If the civil surgeon had to make a required referral in Part 8, Part 9 would be completed by the health care professional who receives the referral. Their personal information and details will be provided in this section. This is only for required referrals and not recommended referrals. 

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We hope these Form I-693 instructions make you feel a little more comfortable about your medical examination. This is one step in your immigration journey where you don’t have to do too much yourself. Just go see the doctor, complete the form, and consider any health advice they may give you!

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Frank Gogol

I’m a firm believer that information is the key to financial freedom. On the Stilt Blog, I write about the complex topics — like finance, immigration, and technology — to help immigrants make the most of their lives in the U.S. Our content and brand have been featured in Forbes, TechCrunch, VentureBeat, and more.

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