Can the same doctor do both I-693 and N-648?

Yes — any USCIS-designated civil surgeon or licensed medical doctor (DO/MD) authorized to practice in the U.S. can complete the N-648; only civil surgeons can sign the I-693. SimplyCare offers both.

Do I need both forms?

Most people only need one. You need the I-693 when applying for a green card (Form I-485). You need the N-648 only if you're applying for U.S. citizenship (Form N-400) and want to waive the English and civics tests due to a qualifying medical condition.

Which form takes longer to complete?

The N-648 is significantly more complex. It requires detailed clinical narrative about how a condition prevents the applicant from learning English or U.S. civics. Plan on 60–90 minutes plus a chart review. The I-693 is typically 45–60 minutes.

Does insurance cover either form?

No. USCIS classifies both as administrative immigration forms. Patients pay out-of-pocket; HSA and FSA are accepted at SimplyCare.

Resources · USCIS Forms

I-693 vs N-648: what's the difference?

Both forms are signed by physicians and submitted to USCIS, but they serve completely different purposes at completely different stages of the immigration process. Mixing them up can delay a case by months. Here's the plain-English breakdown.

Form I-693

The Report of Medical Examination and Vaccination Record. Required for almost every adjustment-of-status (green card) application. Confirms the applicant is free of communicable diseases of public health significance and up-to-date on required vaccines.

Learn more about I-693 →

Form N-648

The Medical Certification for Disability Exceptions. Used by naturalization (N-400) applicants who cannot meet the English-language or U.S. civics requirement due to a physical, developmental, or mental impairment. Optional, but powerful.

Learn more about N-648 →

Side-by-side comparison

	I-693	N-648
Filed with	Form I-485 (green card)	Form N-400 (citizenship)
Who signs it	USCIS-designated civil surgeon only	Civil surgeon OR any licensed MD/DO
Main purpose	Public-health screening + vaccines	Waive English & civics test
Includes physical exam?	Yes — full head-to-toe	Focused on the qualifying impairment
TB test required?	Yes (IGRA blood test)	No
Vaccines required?	Yes (full USCIS schedule)	No
Typical visit length	45–60 minutes	60–90 minutes plus chart review
Submitted in sealed envelope?	Yes	No — given directly to applicant
Expires?	No expiration on signed I-693 (current USCIS policy)	Filed with N-400; valid through the case

Which one do you need?

If you're applying for a green card, you need the I-693. If you're already a green-card holder applying for U.S. citizenship and a medical condition prevents you from learning English or passing the civics test, you may benefit from the N-648. The two forms are never substituted for each other.

FAQ

Need an I-693 or N-648?

Dr. Ashok Mehta is a USCIS civil surgeon and completes both forms.

Book Appointment (615) 288-4087