Complete Guide: I-693 Immigration Medical Exam in Houston TX

Form I-693 is the medical exam USCIS requires for adjustment of status. This guide covers what it includes, what to bring and the mistakes that force you to repeat it.

Who needs it?

Anyone applying for permanent residence from inside the United States through Form I-485. Since December 2024, USCIS asks for the I-693 to be filed together with the I-485, not separately.

What the exam includes

• Review of medical and vaccination history
• Complete physical exam
• Tuberculosis testing through an IGRA blood test
• Blood testing for syphilis and gonorrhea depending on age
• Mental health and substance use assessment
• Administration of any missing vaccines

The vaccines

USCIS requires a set of vaccines by age. The COVID-19 vaccine is no longer a requirement. If you have your vaccination card, even from your home country, bring it: it is what prevents repeating doses you already have, and each repeated dose costs money and time.

If you are missing a multi-dose vaccine, the series does not always have to be completed before filing. The physician records what was given and what remains.

The tuberculosis test

For immigration, the IGRA blood test is used, not the skin test. The reason is that IGRA is not affected by the BCG vaccine, which many people received as children in Latin America and which makes the skin test read positive without any infection.

If the result is positive, a chest X-ray is needed. Positive means contact with the bacteria, not active disease.

The sealed envelope

The form is handed over in a closed, signed envelope. Do not open it. An opened envelope invalidates the exam and the whole thing has to be repeated. Keep it exactly as given until you file it.

Mistakes that force a repeat

• Opening the envelope
• Going without your vaccination card
• Not bringing photo ID
• Filing the form outside whatever validity period USCIS currently applies
• Not mentioning a medical condition that later appears in your file

Before you go, verify

USCIS rules change. Check the official I-693 page before your appointment, and you can confirm any office's designation in the USCIS search tool.

Where to do it in Houston

At Clínica Hispana Nueva Salud Little York the immigration medical exam is done walk-in, Monday through Sunday from 9 AM to 9 PM, with everything explained in Spanish.