I-693 Instructions TOC

TABLE OF CHANGES – INSTRUCTIONS

Instructions for Form I-693, Report of Medical Examination and Vaccine Record

OMB Number: 1615-0033

08/24/2021

Reason for Revision: Emergency

Project Phase: OMBReview

Legend for Proposed Text:

• Black font = Current text

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Expires 07/31/2022

Edition Date 07/15/2019

Current Page Number and Section	Current Text	Proposed Text
Pages 1-2, Applicant Instructions	[Page 1] Applicant Instructions How Do I File Form I-693? You must submit a separate Form I-693 for each applicant. There is no filing fee for this form. 1. Carefully read all these instructions, including the Frequently Asked Questions section. 2. Contact a doctor who is designated as a civil surgeon by USCIS to make an appointment. 3. Fill out Part 1. Information About You of Form I-693. Do not sign the form until the civil surgeon tells you to sign it. You must sign in the presence of the civil surgeon. 4. Attend your medical examination appointment and all follow-up examinations, as required. If you have any medical records, including vaccination records, take them with you to the initial appointment. [new] 5. The civil surgeon must give you the completed Form I-693 in a sealed envelope for you to submit to USCIS. Do not accept the form from the civil surgeon unless it is in a sealed envelope. USCIS will return your Form I-693 to you if it is not in a sealed envelope or if the envelope is opened or altered in any way. The civil surgeon should also give you a copy of the completed Form I-693 for your records. …	[Page 1] Applicant Instructions How Do I File Form I-693? You must submit a separate Form I-693 for each applicant. There is no filing fee for this form. 1. Carefully read all these instructions, including the Frequently Asked Questions section. 2. Contact a doctor who is designated as a civil surgeon by USCIS to make an appointment. 3. Fill out Part 1. Information About You of Form I-693. Do not sign the form until the civil surgeon tells you to sign it. You must sign in the presence of the civil surgeon. 4. Attend your medical examination appointment and all follow-up examinations, as required. If you have any medical records, including vaccination records, take them with you to the initial appointment. NOTE: For those applicants who are now required to receive the COVID-19 vaccine, you must complete the COVID-19 vaccine series (for example, 2 doses of Pfizer-BioNTech or Moderna or 1 dose of Janssen COVID-19) and provide documentation of vaccination to the civil surgeon. 5. The civil surgeon must give you the completed Form I-693 in a sealed envelope for you to submit to USCIS. Do not accept the form from the civil surgeon unless it is in a sealed envelope. USCIS will return your Form I-693 to you if it is not in a sealed envelope or if the envelope is opened or altered in any way. The civil surgeon should also give you a copy of the completed Form I-693 for your records. …
Pages 5-7, Civil Surgeon’s Instructions	[Page 5] Civil Surgeon’s Instructions … 4. Part 8. Civil Surgeon Worksheet and Part 10. Vaccination Record. You must fill out this worksheet and provide the results of each component of the medical examination relating to: communicable diseases of public health significance, physical or mental disorders with associated harmful behavior, drug abuse or drug addiction, and vaccinations. You must also include the results of any lab work or other studies required to determine whether the applicant is inadmissible on health-related grounds. [new] 5. Part 9. Referral Evaluation. If you refer the applicant to a local health department or to another physician or clinic, you must also fill out Item Number 5. Required Referral to Health Department or Other Doctor in Part 8. Civil Surgeon Worksheet in Form I-693. The health care professional receiving the referral must fill out and sign Part 9. Referral Evaluation. Do not complete Item Number 5. in Part 8. if the referral is recommended and not required. …	[Page 5] Civil Surgeon’s Instructions … 4. Part 8. Civil Surgeon Worksheet and Part 10. Vaccination Record. You must fill out this worksheet and provide the results of each component of the medical examination relating to: communicable diseases of public health significance, physical or mental disorders with associated harmful behavior, drug abuse or drug addiction, and vaccinations (including the COVID-19 vaccine series, one or two doses, depending on the formulation, and as applicable). You must also include the results of any lab work or other studies required to determine whether the applicant is inadmissible on health-related grounds. NOTE: If you indicate that the applicant may be eligible for blanket waivers for some vaccines but has otherwise completed all other medically appropriate and available vaccination requirements, select the box “Applicant completed vaccination requirements or may be eligible for blanket waivers as indicated above.” 5. Part 9. Referral Evaluation. If you refer the applicant to a local health department or to another physician or clinic, you must also fill out Item Number 5. Required Referral to Health Department or Other Doctor in Part 8. Civil Surgeon Worksheet in Form I-693. The health care professional receiving the referral must fill out and sign Part 9. Referral Evaluation. Do not complete Item Number 5. in Part 8. if the referral is recommended and not required. …
Page 11, Vaccination Requirements	[Page 11] Vaccination Requirements All applicants for adjustment of status must present documents showing they were vaccinated against a broad range of vaccine-preventable diseases. The civil surgeon will review your vaccination history with you to determine whether you have had all the required vaccinations. Make sure you take your vaccination records with you to your appointment with the civil surgeon. NOTE: Do not attempt to meet the requirements before the civil surgeon evaluates you, in case any of the required vaccines are not medically appropriate for you. You can find a list of the required vaccines at www.cdc.gov/immigrantrefugeehealth/exams/medical-examination-faqs.html#6. If you never received certain vaccines, or you are unable to prove you received them, the civil surgeon can provide them to you. You also have the option to ask your family doctor to administer those vaccines to you after your evaluation by the civil surgeon. If you choose that option, show the records to the civil surgeon to note on Form I-693. If you initially did not have documents proving you received all the required vaccines, but later submit those documents, USCIS may grant you a waiver based on the civil surgeon’s certification on Part 10. Vaccination Record of Form I-693. USCIS may also grant you a waiver if the civil surgeon certifies that it is not medically appropriate for you to have one or more of the required vaccines. HHS has determined that a vaccine is “not medically appropriate” if: 1. The vaccine is not recommended for your specific age group; 2. There is a medical reason why it would not be safe to have the vaccine (for example, you are allergic to eggs and/or yeast or you had bad reactions to prior vaccines); 3. You are unable to complete the entire series of a required vaccine within a reasonable amount of time; or 4. For the influenza vaccine, it is not the flu season. If you object to required vaccinations because of sincerely held religious beliefs or moral convictions, you may apply for a waiver of these requirements. If you hold these objections, inform the civil surgeon that you will apply for a waiver. If USCIS denies the waiver application, we may also deny the immigration benefit that you are seeking. For more information about these waivers, visit the USCIS website at www.uscis.gov.	[Page 11] Vaccination Requirements All applicants for adjustment of status must present documents showing they were vaccinated against a broad range of vaccine-preventable diseases. The civil surgeon will review your vaccination history with you to determine whether you have had all the required vaccinations. Make sure you take your vaccination records with you to your appointment with the civil surgeon. NOTE: With the exception of those required to get the COVID-19 vaccine, you should not attempt to meet the vaccination requirements before the civil surgeon evaluates you in case any of the required vaccines are not medically appropriate for you. However, completing the COVID-19 vaccination process before your appointment with a civil surgeon will expedite the immigration medical examination process. You can find information about required vaccines at Technical Instructions for Civil Surgeons | CDC under “Vaccinations” and “COVID-19”. If you never received certain vaccines, or you are unable to prove you received them, the civil surgeon can provide them to you. You also have the option to ask your family doctor to administer those vaccines to you after your evaluation by the civil surgeon. If you choose that option, show the records to the civil surgeon to note on Form I-693. If you initially did not have documents proving you received all the required vaccines, but later submit those documents, USCIS may grant you a waiver based on the civil surgeon’s certification on Part 10. Vaccination Record of Form I-693. USCIS may also grant you a blanket waiver if the civil surgeon indicates that you may be eligible for blanket waivers for some vaccines but have otherwise completed all other medically appropriate and available vaccination requirements. HHS has determined that a vaccine is “not medically appropriate” if: 1. The vaccine is not recommended for your specific age group; 2. There is a medical reason why it would not be safe to have the vaccine (for example, you are allergic to eggs and/or yeast or you had bad reactions to prior vaccines); 3. You are unable to complete the entire series of a required vaccine within a reasonable amount of time; 4. For the influenza vaccine, it is not the flu season; or 5. For the COVID-19 vaccine, it is not routinely available in the state where the civil surgeon practices. If you object to required vaccinations because of sincerely held religious beliefs or moral convictions, you may apply for a waiver of these requirements. If you hold these objections, inform the civil surgeon that you will apply for a waiver. If USCIS denies the waiver application, we may also deny the immigration benefit that you are seeking. For more information about these waivers, visit the USCIS website at www.uscis.gov.

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