I-693 (for a full medical exam, usually in Guangzhou) or the I-693A vaccination supplement are provided by the physician and submitted in a sealed envelope. If the Guangzhou medical exam I-693 is less than 1 year old, you do not need to submit a new one. This new form is a combination of both, the medical and vaccination form!! My civil surgeon told me that he was instructed by our Uncle this is the only form they would accept now!! George, you might be in under the wire??