What Are the Health Requirements for an EB-5 Green Card?

The U.S. Nationality and Immigration Act mandates that all foreign nationals seeking immigrant visas undergo a medical examination as part of the requirements for a visa. This requirement also applies to persons in the U.S. on non-immigrant routes seeking adjustment of status to that of lawful permanent resident.

This article explores the health report requirements for an EB-5 Green Card and how prospective investors in the U.S. can obtain the report faster to qualify for adjustment of status.

Medical Report Requirements for an EB-5 Green Card

EB-5 investors must attend a medical examination and present a medical report certificate along with other supporting documents when filing their EB-5 visa application. This requirement ensures that potential residents are free from any disease that could threaten public health or burden public health facilities.

The forms to be filed and the medical examination process differ for applicants going through consular processing and those undergoing adjustment of status. For both processes, though, you must be sure to bring several documents, including proof of identity, a list of current medications (if applicable), and any relevant medical records (such as vaccination records).

Medical Examination for Consular Processing

EB-5 investors abroad will have to undergo consular processing after obtaining I-526E approval. They’ll file a Form DS-260 immigrant visa application online and upload all required supporting documents. Once the National Visa Center determines the submission is complete, they’ll schedule the investor’s visa interview appointment.

Before the interview, investors must schedule and attend a medical appointment with an authorized panel physician (an embassy-approved doctor). Examinations conducted by other physicians are not acceptable. You must complete the medical exams—which include a physical, a medical history review, blood tests, and possibly a chest X-ray—and all required vaccinations before the scheduled interview date.

After the exams, the panel physician will give the results to you in a sealed envelope or send them directly to the embassy. If they give it to you, do not open the envelope. You must bring the sealed envelope to the interview and hand it to the consular officer. Opening the envelope yourself renders the report invalid.

Medical Examination for Adjustment of Status

U.S.-based EB-5 investors must also submit a medical report and vaccination record when applying for an adjustment of status. The medical report document is known as Form I-693, Report of Immigration Medical Examination and Vaccination Record.

The medical examination must be conducted by a USCIS-approved doctor (a civil surgeon). You must find a civil surgeon around your locality and schedule an appointment. As with the exam for consular processing, the doctor will review your medical history, conduct a physical examination, and test you for specified communicable diseases.

The civil surgeon will then record the examination results on your Form I-693 and give it to you in a sealed envelope for submission to USCIS. You can ask the surgeon for a copy of the form before it is sealed, as USCIS will not accept the form if the envelope’s seal is altered or broken.

Recent USCIS Policy Updates on Form I-693 Filing

As with other aspects of the EB-5 program, USCIS has rolled out several policy updates on Form I-693 filing over the years. Below are some of the most recent updates.

April 2024 Form I-693 Policy Update

On April 4, 2024, USCIS announced that all properly completed Form I-693s signed by a civil surgeon on or after November 1, 2023, will not expire. These forms can be used indefinitely to prove you’re not inadmissible to the U.S. on health grounds. However, a USCIS officer can request further evidence or an updated Form I-693 if they believe yours does not accurately reflect your medical condition.

Prior to this update, a Form I-693 was only valid for two years. This meant that investors had to file a supplementary Form I-693 if their adjustment of status was delayed longer than two years.

The new policy means Green Card applicants don’t have to file multiple Form I-693s even when there are processing delays—so long as they do not contract a disease that could threaten public health within that time.

December 2024 Policy Update

On December 2, 2024, USCIS strongly recommended that U.S.-based EB-5 investors file Form I-693 with their Form I-485, Application to Register Permanent Residence or Adjust Status. Filing a Form I-485 without an I-693 may delay processing due to an RFE.

Before then, USCIS permitted investors to file Form I-693 after submitting their adjustment of status application. This enabled investors to file Form I-485 and lock in their priority date instead of waiting to schedule and attend an appointment with a civil surgeon. Under these rules, USCIS typically requested Form I-693 via a request for evidence (RFE) or during the Green Card interview (where applicable).

With this new policy update, USCIS strongly encourages investors to file their Form I-693 at the same time as their Form I-485 to avoid processing delays. Failing to include the form may result in a request for evidence (RFE), which can significantly slow down adjudication.

January 2025 Policy Update

On January 22, 2025, USCIS announced that they’re waiving the requirement that investors present a record of COVID-19 vaccination on their Form I-693.

As a result, USCIS will no longer issue an RFE or a notice of intent to deny (NOID)—or deny an adjustment of status application—based on the absence of a COVID-19 vaccination record.

March 2025 Policy Update

On March 11, 2025, USCIS confirmed that COVID-19 vaccination is no longer required for immigration medical examinations. This follows the CDC’s update to its Technical Instructions for Civil Surgeons, which removed COVID-19 from the list of required vaccines.

Although Form I-693 still includes a COVID-19 section, civil surgeons are instructed to either mark this section “N/A” or cross it out entirely. As long as the applicant meets all other vaccination requirements, the form remains valid, and USCIS will not issue an RFE or deny the application based on the absence of COVID-19 vaccination documentation.

This update supersedes earlier guidance from January 2025 and simplifies the medical reporting process for EB-5 investors and others adjusting status in the U.S.

Tips for Speeding Up the Form I-693 Completion Timeline

The December 2, 2024, policy update strongly encouraged applicants to file Form I-693 together with their I-485 to help avoid delays. This means you’ll have to schedule an appointment with a civil surgeon, attend the appointment, and receive the results before filing your Form I-485.

With the upcoming backlogs in the set-aside category, obtaining a Form I-693 can cause critical delays to the EB-5 filing process. Investors who are unable to complete their medical examination before filing may still submit their I-526E and I-485 concurrently, but they will likely receive a request for evidence (RFE) for Form I-693 later, which can delay the overall processing timeline.

However, there are ways to speed up the Form I-693 completion timeline to avoid missing the concurrent filing provision.

Obtain Vaccination Records in Advance

Start gathering your vaccination records as soon as you begin the EB-5 process. Do not wait until you’ve concluded due diligence, selected a project, and begun your I-526E filing. Check the USCIS vaccination requirements, ascertain those you already have, and start collecting the necessary documentation while gathering the required documents for your I-526E and I-485 filing.

At the same time, you must secure translated copies in advance if your vaccination records are not in English. Having these records ready before your expected EB-5 petition filing date will enable you to schedule and attend a medical examination as quickly as possible.

Find and Schedule an Appointment With a Civil Surgeon in Advance

Once you have your vaccination records and all other required medical history documents, schedule an appointment with a civil surgeon. You can locate a civil surgeon in your locality using the “Find a Designated Civil Surgeon” tool on USCIS’s website.

Scheduling and attending a medical exam appointment while still in the supporting documentation collection phase of the EB-5 process ensures your Form I-693 will be completed and signed by the time you’re ready to file your EB-5 petition. This way, if you are eligible to file concurrently based on your visa availability and U.S. presence, you can save time that would have been wasted waiting for a medical appointment after collecting documents for other aspects of the EB-5 process, enabling you to concurrently file your I-526E and I-485 before the backlog hits.

While this approach may seem to only save you a few weeks or even days in the short term, avoiding potential backlogs could save you months in the long term, especially if you’re from a high-demand country like China or India.

Start Your EB-5 Journey Today

Whether you’re undergoing consular processing or adjustment of status, attending a medical examination is a mandatory step in your journey to an EB-5 Green Card. If delayed, this process can significantly increase the timeline for EB-5 petition filing. As a result, it’s best you start your EB-5 journey today.

EB5AN can guide you through your immigration process. We’ve helped over 2,700 families from 70+ countries become U.S. permanent residents through the EB-5 program. We provide first-rate, low-risk regional center projects with a 100% USCIS approval rate.

To learn more about the EB-5 process and how you can obtain an EB-5 Green Card faster, book a free one-on-one call with our EB-5 experts today.