When applying for an employment-based green card with an Adjustment of Status Form I-495, there is a requirement to obtain a medical examination from a civil surgeon. A civil surgeon is a medical practitioner specifically designated by USCIS to perform these evaluations.
When going for this exam, it is important to bring a Form I-693 to be filled out, as this is what is used to supplement the green card application. The examination designates whether the applicant is admissible on public health grounds, which is determined by an evaluation of medical and vaccination records, and it includes tests for communicable diseases. These forms are valid up to two years after being filled out. This is specifically relevant to applicants applying while located in the United States and does not apply to those based outside of the U.S.
USCIS has put out a reminder that when applying for an employment-based green card, a Form I-693 should be included. However, if the application has been submitted without the Form I-693, USCIS urges applicants not to send the form in without a Request for Evidence (RFE). USCIS is working to process these applications quickly and by the end of the fiscal year, and the forms being sent in without being requested slows this process down.
If an application has already been submitted without a Form I-693, it would be wise to obtain a medical examination and hold onto the Form I-693 until receiving and RFE. Once sent an RFE, the applicant should send the Form I-693 in a timely manner so that a decision can be made quickly on their application.