Navigating the 1-693 Deficiency Notice: What You Need to Know and Do

Receiving a 1-693 Deficiency Notice can be worrisome for applicants who have submitted their Form I-485, Application to Register Permanent Residence or Adjust Status. However, understanding the reasons behind the notice and knowing what steps to take can help you address the deficiency and move forward in your immigration journey.

What is a 1-693 Deficiency Notice?

A 1-693 Deficiency Notice is a letter sent by the U.S. Citizenship and Immigration Services (USCIS) to inform applicants that their submitted evidence is insufficient. Specifically, it indicates that a completed and signed Form I-693, Report of Immigration Medical Examination and Vaccination Record, has not been submitted with their Form I-485 application.

Sample 1-693 Deficiency Notice

To help you better understand the 1-693 Deficiency Notice, here's a sample of what the notice might look like:

Dear Applicant,

An initial review of evidence submitted with your Form I-485, Application to Register Permanent Residence or Adjust Status, determined that the evidence submitted with your application is deficient for the following reason(s):

A completed and signed Form I-693 was not submitted.

You will be required to submit information and evidence to address these deficiencies.

If you receive an interview notice in the mail, you must bring the information and evidence required to your interview appointment. Failure to bring the information and evidence to your interview appointment may result in the denial of your Form I-485.

If your case does not require an interview, you will receive a Request for Evidence with further instructions.

DO NOT MAIL DOCUMENTS AT THIS TIME. Mailing documents before receiving one of the notices referenced above may delay your case.

For questions about your application, you can use our many online tools ( including our virtual assistant, Emma. If you are not able to find the information you need online, you can reach out to the USCIS Contact Center by visiting

This sample notice highlights the main issue – the lack of a completed and signed Form I-693 – and provides instructions on how to address the deficiency. It also emphasizes the importance of not mailing any documents before receiving further instructions from USCIS, as doing so may cause delays in your case.

By following the steps outlined in the previous section and addressing the deficiencies mentioned in the notice, you can resolve the issue and continue with your immigration application process.

How to Address a 1-693 Deficiency Notice

If you receive a 1-693 Deficiency Notice, you will be required to submit information and evidence to address the deficiency. Here are the steps you should follow:

  1. Schedule an immigration medical examination with a Designated Civil Surgeon. Be sure to review the Vaccination Requirements before your appointment.

  2. Obtain a completed and signed Form I-693 from the civil surgeon. After the examination, the civil surgeon will provide you with the completed form in a sealed envelope. Do not accept it if the envelope is not sealed or has been opened or altered.

  3. Submit your Form I-693 to USCIS. You can submit the form by mail with your Form I-485 or in person at an interview, if required. If you have already filed your Form I-485, you may submit the Form I-693 by mail at the location specified in your most recent communication from USCIS (e.g., a Request for Evidence letter). For more information, refer to the Direct Filing Addresses for Form I-485.

    Note: USCIS generally considers a completed Form I-693 to be valid for 2 years from the date the civil surgeon signed it. It's best to schedule your immigration medical examination close to the time you file your Form I-485 or respond to a Request for Evidence to ensure the results are still valid when the USCIS adjudicates your application. For more information on the validity of Form I-693, see the USCIS Policy Manual Volume 8, Part B, Chapter 4.

  4. Monitor your case status using the USCIS online tools and respond to any further requests for evidence or attend any required interviews.

Avoiding 1-693 Deficiency Notices

To avoid receiving a 1-693 Deficiency Notice, it's a good idea to submit your Form I-693 at the same time as your Form I-485. Doing so can save you time and may eliminate the need for USCIS to issue a Request for Evidence to obtain your Form I-693, which can delay the review of your application.

Remember that USCIS has removed the requirement that civil surgeons must sign Form I-693 no more than 60 days before an individual applies for an underlying immigration benefit, such as Form I-485 or Form I-539, Application to Extend/Change Nonimmigrant Status.

In conclusion, receiving a 1-693 Deficiency Notice can be a hurdle in your immigration journey, but it can be addressed by following the appropriate steps and submitting the required documentation. To avoid any delays in your case, make sure to submit a completed Form I-693 with your Form I-485 application and respond promptly to any additional requests from USCIS.

Navigating the 1-693 Deficiency Notice – Frequently Asked Questions(FAQ)

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