Why Is a Medical Exam Required for Marriage-Based Adjustment?

Under the Immigration and Nationality Act (INA), all applicants for lawful permanent residence must demonstrate that they are not inadmissible on health-related grounds. This applies regardless of how you are obtaining your green card — including through marriage to a U.S. citizen or lawful permanent resident.

The immigration medical examination is performed by a USCIS-designated civil surgeon and results in Form I-693, which documents your health status, vaccination history, and any findings relevant to admissibility. USCIS will not approve your I-485 without a properly completed and valid I-693 on file.

What Is Included in the Marriage-Based Medical Exam?

The civil surgeon will conduct a complete physical examination, review your medical history, order required laboratory tests (including syphilis serology and gonorrhea culture for applicants aged 15 and older), and evaluate your tuberculosis status through a TB skin test or IGRA blood test.

The civil surgeon will also review your vaccination records and administer any vaccines required by USCIS that you have not yet received. Required vaccines include MMR, varicella, hepatitis B, Tdap, influenza, and others depending on your age and medical history.

• Complete physical examination
• Medical history review
• TB testing (skin test or IGRA blood test)
• Syphilis and gonorrhea testing (age 15+)
• Vaccination review and administration of missing vaccines
• Completion and sealing of Form I-693

When Should I Schedule My Exam Relative to Filing I-485?

You can schedule your immigration medical exam before or after filing your I-485. However, timing matters because Form I-693 has a validity window. The civil surgeon must sign I-693 no more than 60 days before you submit it to USCIS, and the completed form is valid for two years from the civil surgeon's signature date.

Many marriage-based applicants choose to complete the medical exam at the same time they file I-485, submitting I-693 together with the initial application package. Others wait until USCIS requests it or until their interview is scheduled. Either approach is acceptable as long as I-693 remains valid when USCIS adjudicates your case.

How Long Does the Process Take?

At ImmigrationMedicalExams.com, we offer 2-day and 3-day processing options so you receive your sealed I-693 quickly. The exam itself typically takes 45–90 minutes. Lab results are usually available within 24–48 hours, after which the civil surgeon completes and seals the form. If you have an upcoming I-485 interview or a USCIS deadline, expedited processing is available.