How Long Is Form I-693 Valid? The One-Application Rule (2025) and When to Get Your Exam
The short answer: a Form I-693 signed on or after November 1, 2023 does not expire on a date. It expires with its application. Under a USCIS policy effective June 11, 2025, the form is valid only for the specific application it was filed with. If that application is denied or withdrawn, the form goes with it, and you need a new immigration medical exam (often called the green card medical exam).
For forms signed since November 2023, use the application-specific validity rule rather than a two-year expiration date.
How the rules changed
| Date | Rule | Applies to |
|---|---|---|
| Before Nov 1, 2023 | Two-year validity window, counted from the civil surgeon’s signature. | Forms signed before Nov 1, 2023 |
| Nov 1, 2023 | No calendar expiration for newly signed forms. | Forms signed on or after Nov 1, 2023 |
| Dec 2, 2024 | Most I-485 filings must include the sealed I-693 at filing. | I-485 applications filed on or after Dec 2, 2024 |
| Jun 11, 2025 | The form is valid only for the application it is filed with. | Forms signed on or after Nov 1, 2023 |
Primary sources: USCIS policy update on I-693 validity (June 11, 2025) and the USCIS alert on filing the I-693 with the I-485.
Forms signed before November 1, 2023
Older forms keep the two-year window, counted from the civil surgeon’s signature, so any form signed before November 1, 2023 has now passed it. If you are holding one, ask your attorney what USCIS expects rather than assuming it can be used.
The one-application rule, in plain terms
The I-693 belongs to one application. While that application is pending, the form stays good, however long the case takes. What ends it:
- Denial. If USCIS denies the application, the form cannot be reused for the next one.
- Withdrawal. If you or your attorney withdraw the application, the same applies.
- A new, separate application. A later filing needs its own exam, even if the earlier form is recent.
The practical effect: every time an application ends without approval, the medical is paid for again. Accuracy and timing matter more than they did before 2025.
Why the exam now comes before filing
Since December 2, 2024, most applicants filing Form I-485 must include the sealed I-693 in the same package, and USCIS may reject an I-485 filed without it. The old habit of filing first and sending the medical later no longer works for most cases. Some applicants are handled differently; your attorney will confirm how the requirement applies to you.
When to get your exam
Put the two rules together: get the exam close to your filing date, but early enough that the sealed form is ready when the rest of the package is.
- Get your filing date from your attorney, or set a realistic one yourself.
- Ask the clinic how long it takes to hand over the sealed form. Lab results must come back first.
- Add a buffer. A positive TB blood test means a chest x-ray; missing vaccine records may mean titers or vaccinations.
- Book so the form is ready a little before filing. Getting it done many months early gains nothing.
Our pillar guide to the immigration medical exam walks through the visit itself, and our checklist of what to bring helps avoid a second trip for missing records.
If your case is denied or withdrawn
Under the current policy, a denied or withdrawn application takes its I-693 with it. If you file again, plan for a new exam with a USCIS-designated civil surgeon as part of that new package. A new exam means new lab work and a new form; vaccines you already received can be documented from your records rather than repeated.
Whether and when to refile are legal questions for your immigration attorney. On the medical side, keep a copy of your previous form and all vaccination records so the next civil surgeon can see what has already been done.
Refiling scenarios
Common situations in general terms; your attorney should confirm what applies to you.
| Situation | Does the old I-693 carry over? | What to expect |
|---|---|---|
| Application still pending, case taking a long time | Yes, it stays with that application | No new exam needed unless USCIS asks |
| Application denied, you file a new one | No | New exam for the new application |
| Application withdrawn, then refiled | No | New exam for the new application |
| USCIS asks for a corrected or new form in a pending case | Depends on what USCIS asks for | Respond to the specific request, starting with your civil surgeon |
| Form signed before Nov 1, 2023, case not yet filed | Two-year window has passed | Ask your attorney; expect a new exam |
Protecting the form you have
Because the form is tied to one application, get it right the first time: check your copy for name, date and signature errors before filing, keep the envelope sealed, and use a clinic that confirms the edition USCIS currently accepts on its Form I-693 page. Our guides on what a civil surgeon is and what the exam costs help you choose, and you can find a clinic near you when you are ready.
Frequently asked questions
Will my I-693 expire if my green card case takes years?
Not if the civil surgeon signed it on or after November 1, 2023. Those forms have no calendar expiration, and under the policy effective June 11, 2025 the form stays tied to the application it was filed with for as long as that application is pending. A long processing time on its own does not require a new exam. The situations that do are the application being denied or withdrawn, or USCIS specifically requesting a new or corrected form.
Can I reuse my I-693 if I file a new I-485 after a denial?
No. Under the policy effective June 11, 2025, a Form I-693 is valid only for the application it was submitted with. Once that application is denied or withdrawn, the form cannot be carried over to a new filing, even if it was signed recently and nothing about your health has changed. You will need a new immigration medical exam with a USCIS-designated civil surgeon. Your attorney can advise on the timing of any refiling.
I had my exam a few months before filing. Is the form still usable?
If the civil surgeon signed it on or after November 1, 2023 and it has not yet been filed with an application, there is no calendar expiration to worry about, and it can generally be included with your I-485. Keep the envelope sealed and check your copy for errors before filing. If your circumstances or filing plans have changed since the exam, ask your attorney to confirm the form still fits the application you are submitting.
What should I do if USCIS sends an RFE about my medical exam?
Read the request closely to see exactly what USCIS is asking for, such as a missing vaccine record, an incomplete TB classification or a new form, and note the response deadline. Contact the civil surgeon who did your exam first, since many issues can be addressed by the original clinic. If the request calls for a full new exam, any designated civil surgeon can perform it. If an attorney represents you, involve them before you respond.