U.S. Department of Homeland Security 

U.S. Citizenship 

and Immigration 

Services 

www.uscis.gov 

U.S. Citizenship and Immigration Services 

Office of the Director 

Camp Springs, MD 20588-0009 

April 4, 2024 PA-2024-09 

Policy Alert 

SUBJECT: Validity of Report of Immigration Medical Examination and Vaccination Record 

(Form I-693) 

Purpose 

U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance in the USCIS Policy 

Manual regarding the evidentiary value of the Report of Immigration Medical Examination and 

Vaccination Record (Form I-693). 

Background 

In general, noncitizens applying for immigration benefits who are required to demonstrate that they 

are admissible, such as adjustment of status applicants, must submit a Form I-693 to show they are 

free from any conditions that would render them inadmissible under the health-related grounds.1 

Since December 9, 2021, USCIS has considered a properly completed Form I-693 to retain its 

evidentiary value (in other words, how long a Form I-693 can be used as evidence to show that the 

applicant is not inadmissible under the health-related grounds) for 2 years after the date the civil 

surgeon signed the form, regardless of when the underlying application was submitted. 

Effective November 1, 2023, the Centers for Disease Control and Prevention (CDC) updated their 

Tuberculosis Technical Instructions for Civil Surgeons to require civil surgeons share certain medical 

data from Form I-693 directly with CDC electronically.2 Additionally, CDC and USCIS have 

collaborated to improve the reporting of public health information collected on Form I-693 by civil 

surgeons to local U.S. health departments. Based on these developments and in consultation with 

CDC, USCIS has determined that a properly completed Form I-693 that is signed by a civil surgeon 

on or after November 1, 2023, does not expire and can be used as evidence to show that the applicant 

is not inadmissible under the health-related grounds indefinitely. 

Before November 1, 2023, however, civil surgeons were not required to share or report certain 

information to CDC electronically. Therefore, USCIS, in consultation with CDC, has determined that 

1 See INA 232 (immigration medical examination) and INA 212(a)(1) (health-related grounds of inadmissibility). See 8 

CFR 232. 2 See CDC’s Tuberculosis Technical Instructions for Civil Surgeons. According to the instructions, civil surgeons must 

enter information relating to applicants with tuberculosis classifications into eMedical, an electronic health processing 

system through which appropriate notifications to health departments are made. 

To provide feedback on this update, email USCIS at policyfeedback@uscis.dhs.gov. 
 

 

PA-2024-09: Validity of Report of Immigration Medical Examination and Vaccination Record 

(Form I-693) 

Page: 2 

a properly completed Form I-693 signed by a civil surgeon before November 1, 2023 continues to 

retain evidentiary value for 2 years from the date of the civil surgeon’s signature.3 

This guidance, contained in Volume 8 of the Policy Manual, is effective immediately and applies to 

all Forms I-693 signed by the civil surgeon on or after November 1, 2023. The guidance contained in 

the Policy Manual is controlling and supersedes any related prior guidance. 

Policy Highlights 

• Clarifies that a properly completed Form I-693 signed by a civil surgeon on or after November 

1, 2023, retains its evidentiary value and does not expire. 

• Clarifies that a properly completed Form I-693 signed by a civil surgeon before November 1, 

2023, continues to retain its evidentiary value for 2 years from the date of the civil surgeon’s 

signature. 

• Reiterates that USCIS officers have the discretion to request further evidence or a new or 

updated Form I-693, even if the original Form I-693 submitted is otherwise valid, if they have 

reason to believe the Form I-693 submitted does not accurately reflect the applicant’s medical 

condition. 

Summary of Changes 

Affected Section: Volume 8 > Part B > Chapter 4 > Section C, Documentation Completed by Civil 

Surgeon 

• Renames Subsection 4 to “Evidence, Validity, USCIS Discretion, and Burden of Proof,” and 

revises content throughout the subsection. 

USCIS may also make other minor technical, stylistic, and conforming changes consistent with this 

update. 

Citation 

Volume 8: Admissibility, Part B, Health-Related Grounds of Inadmissibility, Chapter 4, Review of 

Medical Examination Documentation [8 USCIS-PM B.4]. 

3 Through policy and consultation with CDC, the exams for certain Afghan nationals who arrived in the United States 

during Operation Allies Welcome (OAW) and received the full immigration medical examination documented on Form 

I-693 retain evidentiary value for 3 years from the date of the civil surgeon’s signature.