USCIS Medical Exam (Form I-693) for Guatemalans in the US: Civil Surgeon, Sealed Envelope, Validity (2026)

This page is general information, not legal advice. It summarizes these sources, all checked October 15, 2026:

• the USCIS Form I-693 page
• the I-693 instructions
• the USCIS Policy Manual
• the State Department’s Guatemala pages
• the USCIS fee schedule (Form G-1055)

Your own case depends on your immigration history. For your situation, use a licensed US immigration attorney.

Quick summary (checked October 15, 2026):

• Are you a Guatemalan in the United States applying for a green card through adjustment of status (Form I-485)? Then a USCIS-designated civil surgeon does the medical exam in the US and reports it on Form I-693.
• Since December 2, 2024, USCIS says you must file the I-693 (or a partial I-693) together with your I-485, or USCIS may reject the I-485. Some K-visa entrants and other groups already did a panel exam abroad. For them, the partial-form rule is conditional (see below).
• USCIS charges $0 to file the I-693. The doctor’s fee is separate and set by each civil surgeon.
• If the civil surgeon signs on or after July 3, 2025, USCIS accepts only the 01/20/25 edition of the form.
• A form signed on or after November 1, 2023 is tied to the application it is filed with. If that application is withdrawn or denied, you need a new one.
• If your relative is getting the green card from Guatemala, this is not your exam. An embassy panel physician in Guatemala City does that one. See the immigrant visa interview in Guatemala City.

Civil surgeon or panel physician: which exam is yours

There are two kinds of immigration medical exam. Which one you need depends on where the green card is processed: in the US through adjustment of status, or through the embassy.

We found no Guatemala-specific rule in the USCIS form page, the instructions or the Policy Manual sections we checked. A Guatemalan adjusting status follows the same I-693 process as any other nationality. The Guatemala angle is in your documents (below) and in the exam you may already have done in Guatemala City.

Full I-693 or partial I-693

USCIS says the I-693 is how you show that you are not inadmissible to the United States on health-related grounds. The groups below submit only a partial Form I-693 when they file to adjust. The partial form is Parts 1 to 5, Part 7 and Part 10 (Vaccination Record).

If you entered on a K-1, K-2, K-3 or K-4 visa, the K row sets two conditions. Check both before you file:

• Timing: you did the panel exam outside the US no more than 1 year before you file to adjust.
• Vaccination record: it was not properly completed and included as part of that exam.

USCIS adds a warning: you may need a new immigration medical exam if either of these applies:

• your exam outside the US revealed a Class A medical condition, or
• there is reason to believe you acquired one after admission or parole into the US.

The I-693 instructions say which parts you must complete.

Before the appointment

The I-693 instructions say to submit a separate Form I-693 for each applicant, then:

1. Read all the instructions, including the Frequently Asked Questions section.
2. Contact a doctor designated as a civil surgeon by USCIS to make an appointment.
3. Fill out Part 1, Information About You. Do not sign until the civil surgeon tells you to. “You must sign in the presence of the civil surgeon.”
4. Attend the appointment and all follow-up exams required. Take any medical records you have, including vaccination records, to the first appointment.

Finding a civil surgeon

The instructions say to search uscis.gov for the Find a Doctor tool, which explains how to look for a civil surgeon in your area. The current I-693 page links a direct address for that tool. It returned an error when we tried it on October 15, 2026, so start from the search box on uscis.gov.

You may be eligible for an exam by a blanket designated civil surgeon, the instructions say, if you are one of these:

• a member or veteran of the US armed forces
• a dependent of one
• a refugee adjusting status

USCIS points to its Policy Manual guidance on blanket designated civil surgeons.

What to bring: ID and Guatemalan documents

Photo ID. The civil surgeon will ask you to verify your identity. Bring a valid government-issued photo ID, for example your unexpired passport or driver’s license.

Children under 14. Their identity documents must show:

• the child’s name
• date and place of birth
• both parents’ full names
• any other identifying information

The instructions accept birth certificates (with a translation, if necessary) or affidavits.

Guatemalan birth certificates. The State Department’s Guatemala civil-documents page is written for visa applicants. It tells applicants to “request birth certificates from RENAP (National Registry of Persons) and not from your city or town”. If you need a new certificate for a child’s exam, RENAP is the issuing authority that page names.

Translations. The USCIS Policy Manual says any foreign-language document submitted with a benefit request must come with a full English translation. The translator must certify two things: that the translation is complete and accurate, and that they are competent to translate into English. “A summary of a document prepared by a translator is unacceptable.” The Policy Manual cites 8 CFR 103.2(b)(3) for this rule.

Apostille. We found no apostille requirement for this USCIS filing in the sources we checked. Do not assume one from the translation rule.

Vaccination records. The instructions ask you to bring them. The State Department’s Guatemala City page also notes that children are required to have certain vaccinations before they can enroll in school in the United States. It recommends bringing your child’s complete vaccination records with you to the United States. We did not find a rule on whether a civil surgeon needs a translation of a Guatemalan vaccination record, so ask the clinic when you book.

Cost

• USCIS filing fee for Form I-693: $0 (USCIS fee schedule G-1055; the G-1055 page was last reviewed October 7, 2026).
• The exam: “Fees for immigration medical examinations are established by the civil surgeon. Fees may vary by civil surgeon.”

We did not get a price from any clinic, so we cannot give a typical amount or a processing time. Ask for the full price in writing, including any follow-up visits.

The sealed envelope: how to submit

After the exam, the civil surgeon must give you the completed and signed I-693 in a sealed envelope. “Do not accept the Form I-693 if it is not in a sealed envelope.” And: “You (not the civil surgeon) must submit your Form I-693 to USCIS.”

If the lockbox rejects your package. The lockbox may reject a package for reasons such as a missing fee or signature, and return it with the I-693 envelope opened. In that case, USCIS says you may refile with:

• the original opened I-693
• any supporting documents the civil surgeon put in the envelope, in its original envelope
• a copy of the rejection notice

Note that the I-693 instructions PDF still tells applicants to submit the form in the sealed envelope. The online-upload steps above come from the current USCIS I-693 webpage.

How long the I-693 is valid

The USCIS Policy Manual sets validity by the date the civil surgeon signed:

In the Policy Manual’s words, a form signed on or after November 1, 2023 “can only be used as evidence to show that the applicant is not inadmissible under the health-related grounds for the entire period the immigration benefit application with which the Form I-693 is submitted is pending”. Why do older forms get the 2-year rule? USCIS explains that before that date, civil surgeons were not required to report certain information to CDC electronically.

The two sources do not say the same thing. The I-693 instructions PDF (checked October 15, 2026) still states that the form remains valid for two years from the civil surgeon’s signature. We are showing both rather than merging them. If your exam is close to either limit, ask your attorney which applies to you.

Even a valid I-693 is not final. An officer may request more evidence or a new or updated I-693 if they have reason to believe either of these:

• your medical condition has changed, or
• the form does not accurately reflect it.

The Policy Manual says the medical requirement is generally met when all of these are true:

• A USCIS-designated civil surgeon did the exam under the official rules.
• You and the doctor both signed and properly completed the current edition.
• You submitted it as the instructions say.
• It shows no Class A condition and compliance with vaccination requirements (or a waiver).
• USCIS confirms it is valid when it decides your application.

If any one of those fails, the officer may issue a denial, a Request for Evidence or a Notice of Intent to Deny.

Which edition of the form

USCIS lists the edition date as 01/20/25:

• Civil surgeon signed on or before July 2, 2025: you must use the 03/09/23 or the 01/20/25 edition.
• Civil surgeon signs on or after July 3, 2025: USCIS accepts only the 01/20/25 edition.

USCIS says you can find the edition date at the bottom of the page on the form and instructions. (USCIS I-693 page last reviewed July 24, 2026.)

Official page: uscis.gov/i-693.

What we could not confirm

These were not established in the sources we checked on October 15, 2026, so this page does not state them:

• A typical civil-surgeon price or how long the exam takes.
• The current vaccine-by-vaccine list. The instructions PDF contains older COVID-19 wording that we are not treating as current.
• Any separate biometrics step or fee for the I-693.
• Any Guatemala-specific USCIS rule, apostille requirement, or Guatemalan consulate service for this exam.

Related

• Immigrant visa interview in Guatemala City: the panel-physician exam for relatives processing from Guatemala.
• Affidavit of support (I-864) for a Guatemalan relative