Complete Guide on the Health Requirements for an EB-5 Green Card

While most discussions about the EB-5 program focus on investment rules, job creation, and project selection, there is also an important health requirement. This criterion does not relate to your wealth, business background, or investment ability. Instead, it ensures that you enter the U.S. without posing a public health risk and meet vaccination requirements set by law.

For EB-5 applicants, the medical examination and related documentation often come near the final stage of the immigration process. However, delays or mistakes with this step can hold back Green Card approval. And since health rules can feel complex, especially with frequent policy updates, investors need clear guidance.

In this article, we will explain the health requirements for an EB-5 Green Card so you can plan ahead and avoid delays in your EB-5 journey.

Understanding EB-5 Medical Report Requirements

EB-5 investors are required to complete a medical exam and submit a medical report when applying for their Green Card. This ensures that new residents do not have any health conditions that could pose a risk to public health or place a burden on healthcare systems.

The medical forms and examination process vary depending on whether you are applying through consular processing or adjustment of status. In both cases, you should bring important documents, such as proof of identity, a list of any current medications, and relevant medical records, including vaccination history

That said, let’s closely examine how the medical examination works in both scenarios.

EB-5 Medical Exams for Applicants Abroad

EB-5 investors living abroad go through consular processing after their I-526E petition is approved. Then they submit a Form DS-260 online along with all required documents. Once the National Visa Center confirms the submission is complete, they schedule a visa interview.

Before the interview, investors must:

• Schedule a medical exam with an authorized panel physician approved by the U.S. embassy as exams from other doctors are not accepted.
• Complete a full checkup, which includes a physical exam, review of medical history, blood tests, and possibly a chest X-ray.
• Receive all required vaccinations before the interview date.

After the exam, the panel physician will provide the results in a sealed envelope or send them directly to the embassy. If you receive the envelope, do not open it because opening the envelope yourself makes the report invalid. Instead, you are to bring it to your interview and hand it to the consular officer.

EB-5 Medical Exams for U.S.-Based Applicants

U.S.-based EB-5 investors applying for an adjustment of status must also submit a medical report and vaccination record. This is done using Form I-693, Report of Immigration Medical Examination and Vaccination Record. Here, you will have to schedule an exam with a USCIS-approved civil surgeon in your area.

The civil surgeon will review your medical history, perform a physical exam, and test for specified communicable diseases. The results are then recorded on Form I-693 and placed in a sealed envelope for submission to USCIS. You may request a copy before it is sealed, but do not break the seal afterward, as USCIS will reject it.

Latest USCIS Policy Revisions on Form I-693 Filing

Below is an overview of how USCIS policies on Form I-693 filing have changed several times in recent years:

April 2024 Policy Update

On April 4, 2024, USCIS announced that any Form I-693 signed by a civil surgeon on or after November 1, 2023, will no longer expire. This means investors can use these forms indefinitely to show they are not inadmissible to the U.S. on health grounds. However, a USCIS officer may still request an updated form if they believe your medical report does not accurately reflect your current health.

Before this change, a Form I-693 was valid for only two years, which often required investors to submit a new form if their adjustment of status took longer than that. The new policy eliminates this requirement, as long as applicants do not develop a disease that could threaten public health.

Note: This indefinite validity rule was later revised. See the June 2025 update below.

December 2024 Policy Update

On December 2, 2024, USCIS began requiring U.S.-based EB-5 investors to file Form I-693 at the same time as Form I-485, the Application to Register Permanent Residence or Adjust Status. Submitting Form I-485 without Form I-693 may result in the application being rejected.

Previously, investors could submit Form I-693 after filing Form I-485, allowing them to secure their priority date while waiting for a civil surgeon appointment. Under the new guidance, submitting both forms together helps avoid processing delays and reduces the chance of receiving an RFE.

January 2025 Policy Update

On January 22, 2025, USCIS announced that COVID-19 vaccination records are no longer required for Form I-693. As a result, missing COVID-19 documentation will no longer trigger an RFE, a notice of intent to deny (NOID), or a denial of the adjustment of status application.

March 2025 Policy Update

On March 11, 2025, USCIS confirmed that COVID-19 vaccination is officially not required for immigration medical exams. This aligns with the CDC’s updated instructions for civil surgeons, which removed COVID-19 from the list of required vaccines. Even though Form I-693 still has a COVID-19 section, civil surgeons should mark it “N/A” or cross it out.

As long as all other vaccination requirements are met, the form remains valid, and USCIS will not issue an RFE or deny the application based on COVID-19 vaccination. This update supersedes the January 2025 guidance and makes the medical reporting process simpler for EB-5 investors and other applicants adjusting status in the U.S.

June 2025 Policy Update

On June 11, 2025, USCIS reversed the indefinite validity introduced in April 2024. Form I-693 is now valid only for the specific immigration benefit application it was submitted with. If that application is denied or withdrawn, the form is no longer valid, and applicants must complete a new medical exam before reapplying. This applies to all applications pending or filed on or after June 11, 2025. Note that rejected applications (where USCIS returns the package) are an exception: applicants may resubmit the same I-693 along with a copy of the rejection notice.

How to Complete Your Form I-693 Faster

To comply with the guidance to file Form I-693 and Form I-485 together, you must schedule a medical exam with a civil surgeon, attend the appointment, and receive the completed report before filing your I-485. If your medical exams are not completed in time, you can still submit Form I-526E and I-485 concurrently. However, USCIS will likely issue a Request for Evidence (RFE) for Form I-693 later, which can slow down the overall process.

With upcoming backlogs in the set-aside category, early preparation is more important than ever to avoid unnecessary delays. Here are practical steps to complete Form I-693 quickly and take advantage of the concurrent filing option:

1. Gather Vaccination Records Early

To schedule and attend a medical examination as quickly as possible, do the following:

• Start collecting vaccination records as soon as you begin the EB-5 process.
• Compare your records with USCIS vaccination requirements and start organizing those you don’t have.
• Translate any records that are not in English.

2. Schedule a Civil Surgeon Appointment Early

After gathering your vaccination records and medical history documents, it is important to schedule an appointment with a USCIS-approved civil surgeon. You can find a local civil surgeon using the “Find a Designated Civil Surgeon” tool on the USCIS website.

Completing your medical exam during the document collection phase ensures that Form I-693 will be ready and signed when you file your EB-5 petition. You can then file Form I-526E and I-485 concurrently, rather than waiting for a later appointment, which could delay the process. Taking this step early may only save a few weeks in the short term, but it can prevent months of delays caused by backlogs, especially for investors from high-demand countries like China or India

Ensure a Smooth EB-5 Process With EB5AN

Health requirements are a standard part of the EB-5 Green Card process. While extra steps in immigration may seem inconvenient, they ensure that new residents meet public health standards in the United States. Thankfully, recent USCIS policy updates have made the process more predictable.

At every stage of an EB-5 application, starting early is key to avoiding delays, and EB5AN is here to help. More than 3,000 families from over 70 countries have selected EB-5 projects sponsored by EB5AN regional centers. Our expert team has more than a decade of experience and offers clients high-quality, low-risk EB-5 regional center projects with a 100% USCIS project approval rate.

If you would like to know more about your EB-5 investment options, book a free call with our expert team today.