USCIS Form I-693
The exam is used to complete the medical portion of your adjustment of status application. Once complete, your Form I-693 is signed and sealed for submission.
USCIS Civil Surgeon · Houston, TX
Adjustment of Status & Immigration Medical Exams
Rios Healthcare provides USCIS immigration medical exams and Form I-693 completion with Nicolin Neal, MD, a USCIS-designated Civil Surgeon in Houston.
Need primary care, labs, X-ray, or other services? Return to Rios Healthcare.
Guided by an experienced civil surgeon
The immigration medical exam can feel confusing. Our goal is to make the process organized, respectful, and clear from your first visit through your sealed Form I-693.
Required testing
Required immigration screening tests are handled through the civil surgeon process. Outside testing for certain required items generally cannot be accepted under CDC instructions.
Vaccination review
Please bring any vaccine records you have. Requirements vary by age, history, documentation, and current CDC/USCIS requirements.
Estimated pricing
Total cost depends on age, vaccine history, required labs, and whether additional documentation, vaccines, treatment records, or follow-up are needed.
| Amount | What it covers |
|---|---|
| $300 | Immigration medical exam, related follow-up for the exam, and completion of Form I-693, provided in a sealed envelope when complete. |
| $80 | Tuberculosis screening. Required TB screening is handled through the civil surgeon process. |
| $35 | Syphilis screening when required. CDC instructions generally require syphilis testing to be ordered by the civil surgeon at the time of the immigration medical exam. |
| $45 | Gonorrhea screening when required. CDC instructions generally require gonorrhea testing to be ordered by the civil surgeon at the time of the immigration medical exam. |
| ~$20 | Approximate per-test cost for vaccine titers such as MMR, Varicella, or Hepatitis B when needed. |
Have outside vaccine records or titers?
Bring them with you. Vaccine records and titers may be considered when appropriate, but required immigration screening labs must follow civil surgeon instructions.
What to bring
Bringing the right documents helps prevent delays and keeps the process moving.
Valid government ID
Bring a passport, driver’s license, state ID, or other acceptable government-issued identification.
Vaccination records
Bring all vaccine documentation available to you, including records from outside the U.S. if you have them.
Relevant medical records
Bring records related to TB, syphilis, gonorrhea, prior treatment, chronic conditions, medications, pregnancy, or prior immigration medical exams.
How long does it take?
In uncomplicated cases, your sealed Form I-693 can often be ready in about 5–7 days, depending on lab results, vaccine documentation, and follow-up needs.
Day 1
Initial visit, exam, record review, vaccine review, and required screening tests are started.
Days 1–7
Lab results are pending. TB screening is often the rate-limiting step.
Follow-up
We review results and let you know if additional vaccines, records, or treatment documentation are needed.
Completion
Once complete, your Form I-693 is signed and placed in a sealed envelope. Do not open the sealed envelope.
Important notes
Do not open the sealed envelope
USCIS requires the completed Form I-693 to remain sealed. If the envelope is opened, USCIS may reject the form.
No approval guarantee
The medical exam supports completion of Form I-693. It does not guarantee approval of any immigration application.
Requirements can vary
Required vaccines, testing, and follow-up depend on age, medical history, documentation, and current CDC/USCIS instructions.
Schedule your exam
We’re here to help with this part of your journey.
Call Rios Healthcare to schedule your immigration medical exam with Dr. Nicolin Neal.