The short answer
Under USCIS policy updated on June 11, 2025, a Form I-693 signed by a civil surgeon on or after November 1, 2023 is valid only while the application it was submitted with is pending. If that application is withdrawn or denied, the I-693 is no longer valid and a new exam is needed for a new application.
Since December 2, 2024, USCIS also requires most adjustment of status applicants to submit Form I-693 together with Form I-485. An I-485 filed without the medical exam may be rejected.
What this means for you
- Schedule your exam close to the date you (or your attorney) plan to file the I-485.
- Allow time for lab results — usually a few business days — so the sealed envelope is ready when you file.
- Do not open the sealed envelope. USCIS returns forms that have been opened or altered.
- If your earlier application was withdrawn or denied, you will need a new I-693 for the new application.
- Timing rules can change. Check the current Form I-485 instructions or ask your immigration attorney.
Older forms (signed before November 1, 2023)
Different validity rules applied to forms signed before November 1, 2023. If you have an older I-693, ask your attorney whether it can still be used.
Official sources
Common questions
Not under the current rule. A Form I-693 signed on or after November 1, 2023 is valid while the application it was submitted with is pending. The older 2-year rule no longer applies to these forms.
Yes. Since December 2, 2024, USCIS requires most applicants to submit Form I-693 together with Form I-485.
The I-693 submitted with it is no longer valid. A new application needs a new medical exam.
Close to your planned filing date, leaving a few business days for lab results. We usually have same-week appointments, including Saturdays.
Medically reviewed by Dr. Rekha Manghnani, MD, USCIS-designated civil surgeon · Last updated October 2026. This page is general information, not legal advice.