US Civil Surgeons and the I-693

[bobbyA]

I read that you guys mentioned about yellow book and 2 sealed envelopes, one of which is to be turned in for visa interview, and that the yellow book and the other sealed envelope is to be turned in later for AOS. But I just called the Health Care Center of Guangdong International Travel for the medical exam. They said they would do the vaccinations (4 shots) with the medical exam on the same day. The DS-3025 will be sealed in the envelope with the other papers which is to be turned in to the GZ consulate, and only a copy of the vaccination record will be given for us. Would we have any problems with this later for AOS?

 

And by the way, would it be okay to get 4 shots in a day???? That sounds a lot!!!

 

Thanks!!

If did the vaccinations with immigrations medical prior to visa interview, the medical center may have done a DS-3025 (Vaccinations record) and sealed this in an envelope for you to file later to USCIS when adjusting status, this allows you to not have to do an I-693. Do not open the sealed envelope.

 

Yes can do all 4 shots in one day my wife did.

 

If you do like My wife and Carl's wife, do medical prior to interview, and then return for vaccinations after interview, getting only a yellow book, you will have to deal with a US Civil surgeon later in the states to get an I-693 done, and possibly have to deal with a doctor that wants to rip you off.

 

Perhaps things change from time to time, but my wife (fiancee at the time) got her vaccination (3 shots) after her interview (July 2011), and she was given 4 sets of documents: (1) DS-3025 in a sealed envelop addressed "USCIS Vaccination" and was told it's to be used for AOS, (2) a copy of the DS-3025, (3) yellow book, (4) an appendix - vaccination worksheet showing doses.

 

We filed her AOS at the end of September with her sealed DS-3025 (without going to a CS for an I-693), a photocopy of the second copy of DS-3025, and color copy of her yellow book. She got 3 NOA's dated October 3rd and did her biometrics on October 25th. Her I-485 was transferred to CSC on October 21st. Currently waiting for her EAD/AP.

 

I know of a Canadian lady on VJ (filed k-1 AOS same day as my wife) who went to a CS and got an I-693 for her AOS. USCIS gave her an RFE because her CS made a mistake in her I-693. She said she wished she had only sent in her DS-3025.

 

I've read a number of people who did AOS successfully by their DS-3025 alone without going to a CS, so that's what I did for my wife. We'll just deal with the RFE if and when we get one. Someone at VJ reasons, in some cases the USCIS misplace applicant's medical report and request a full medical. If that's the case, I might as well have my wife wait in case she needs to do medical and vaccination all over again.

 

My argument is, she should only do what is necessary when it comes to medical stuff. For instance, I suggested to her that she should only get her vaccination after she passes her k-1 interview. There is no point in getting drugged if she fails her interview

 

I don't know what is the reasoning behind transcribing a DS-3025 to I-693 anyway. Is it for a US doctor to approve what was done at a foreign USCIS authorized medical facility? Or is it to help generate revenue for US doctors? Or could it be our own misinterpretation of the poorly written I-693 instructions?

[dnoblett]

Perhaps things change from time to time, but my wife (fiancee at the time) got her vaccination (3 shots) after her interview (July 2011), and she was given 4 sets of documents: (1) DS-3025 in a sealed envelop addressed "USCIS Vaccination" and was told it's to be used for AOS, (2) a copy of the DS-3025, (3) yellow book, (4) an appendix - vaccination worksheet showing doses.

 

We filed her AOS at the end of September with her sealed DS-3025 (without going to a CS for an I-693), a photocopy of the second copy of DS-3025, and color copy of her yellow book. She got 3 NOA's dated October 3rd and did her biometrics on October 25th. Her I-485 was transferred to CSC on October 21st. Currently waiting for her EAD/AP.

 

I know of a Canadian lady on VJ (filed k-1 AOS same day as my wife) who went to a CS and got an I-693 for her AOS. USCIS gave her an RFE because her CS made a mistake in her I-693. She said she wished she had only sent in her DS-3025.

 

I've read a number of people who did AOS successfully by their DS-3025 alone without going to a CS, so that's what I did for my wife. We'll just deal with the RFE if and when we get one. Someone at VJ reasons, in some cases the USCIS misplace applicant's medical report and request a full medical. If that's the case, I might as well have my wife wait in case she needs to do medical and vaccination all over again.

 

My argument is, she should only do what is necessary when it comes to medical stuff. For instance, I suggested to her that she should only get her vaccination after she passes her k-1 interview. There is no point in getting drugged if she fails her interview

 

I don't know what is the reasoning behind transcribing a DS-3025 to I-693 anyway. Is it for a US doctor to approve what was done at a foreign USCIS authorized medical facility? Or is it to help generate revenue for US doctors? Or could it be our own misinterpretation of the poorly written I-693 instructions?

Note: getting vaccinated is not "Getting Drugged" A vaccination is the process of getting infected with the disease in a way that you get the immunity to the disease without coming down with the disease. There are no drugs involved..

 

Reasoning for getting a DS-3025 transcribed is for cases where the DS-3025 is not complete a vaccination was missed, or in cases where the visa holder was not vaccinated overseas.

 

Again K-Visas can defer this to after coming to the USA, K-Visas are considered to be non-immigrant, so have no vaccinations requirement for the visa.

 

In the past the med center would do the vaccination, but fail to issue a DS-3025 to K-Visa applicants, and only issue a yellow book, causing the need to do an I-693 later in the states.

[bobbyA]

Perhaps things change from time to time, but my wife (fiancee at the time) got her vaccination (3 shots) after her interview (July 2011), and she was given 4 sets of documents: (1) DS-3025 in a sealed envelop addressed "USCIS Vaccination" and was told it's to be used for AOS, (2) a copy of the DS-3025, (3) yellow book, (4) an appendix - vaccination worksheet showing doses.

 

We filed her AOS at the end of September with her sealed DS-3025 (without going to a CS for an I-693), a photocopy of the second copy of DS-3025, and color copy of her yellow book. She got 3 NOA's dated October 3rd and did her biometrics on October 25th. Her I-485 was transferred to CSC on October 21st. Currently waiting for her EAD/AP.

 

I know of a Canadian lady on VJ (filed k-1 AOS same day as my wife) who went to a CS and got an I-693 for her AOS. USCIS gave her an RFE because her CS made a mistake in her I-693. She said she wished she had only sent in her DS-3025.

 

I've read a number of people who did AOS successfully by their DS-3025 alone without going to a CS, so that's what I did for my wife. We'll just deal with the RFE if and when we get one. Someone at VJ reasons, in some cases the USCIS misplace applicant's medical report and request a full medical. If that's the case, I might as well have my wife wait in case she needs to do medical and vaccination all over again.

 

My argument is, she should only do what is necessary when it comes to medical stuff. For instance, I suggested to her that she should only get her vaccination after she passes her k-1 interview. There is no point in getting drugged if she fails her interview

 

I don't know what is the reasoning behind transcribing a DS-3025 to I-693 anyway. Is it for a US doctor to approve what was done at a foreign USCIS authorized medical facility? Or is it to help generate revenue for US doctors? Or could it be our own misinterpretation of the poorly written I-693 instructions?

Note: getting vaccinated is not "Getting Drugged" A vaccination is the process of getting infected with the disease in a way that you get the immunity to the disease without coming down with the disease. There are no drugs involved..

 

Reasoning for getting a DS-3025 transcribed is for cases where the DS-3025 is not complete a vaccination was missed, or in cases where the visa holder was not vaccinated overseas.

 

Again K-Visas can defer this to after coming to the USA, K-Visas are considered to be non-immigrant, so have no vaccinations requirement for the visa.

 

In the past the med center would do the vaccination, but fail to issue a DS-3025 to K-Visa applicants, and only issue a yellow book, causing the need to do an I-693 later in the states.

 

OK Dan, I apologize for playing on the words "vaccination" and "drugs". My wife was uncomfortable for a couple of days after her vaccination. I'm not in the medical field so I'll leave it at that.

 

"Incomplete Vaccination" confused many people because most if not all DS-3025 will have the "incomplete" box checked. But we need to let people know about the "waiver". I for one believe that the Guangzhou medical facility knows what they're doing and they do provide what is necessary for AOS vaccination. Otherwise they would not have given us the second sealed envelop and told us it's for AOS.

 

My post was a follow up to JJ2011's post about "sealed envelops" with my wife's k-1/AOS medical experience for future reference. If I were JJ2011, I would get vaccination after interview so they'll have a second sealed vaccination envelop for AOS. But I'd rather get vaccination (and DS-3025) in China than deal with CS (and I-693) in the USA

[Da Niao]

Re: the instructions to form i-693 which state "If you were admitted as a K-1 fiancée...and you received a medical examination prior to admission, then you are not required to have another medical examination..." on the one hand, and the civil surgeons who insist on giving and charging for a second medical examination (with chest x-ray, TB skin test, etc.) on the other hand, these civil surgeons point out that on the form i-693 itself the following wording is still found: "Part 2:

Summary of Medical Examination (to be completed by the civil surgeon)" and just below that "I certify under penalty of perjury that ... I performed this examination". They are faced with instructions which state that the exam is not required, but they are expected to certify under penalty of perjury that they have performed the examination. So it is understandable that some may not be willing to ignore the actual meaning of what they are signing. In order to save my fiancée a second exam, chest x-ray, and a TB test with nine months of Isoniazid pills (75% of Asians test positive because of immunizations which they have had in prior years), I plan to seek further clarification about the conflict between the form instructions and the wording of the CS Certificate in Part 3 of the Form i-693.

[Da Niao]

Further research on this matter has not shed any light on the situation, it has uncovered further contradictions and unclear language, making it next to impossible for applicants and civil surgeons to understand how to complete form I-693.

 

It is strongly recommended to follow Dan Noblett's advice about having all vaccinations performed in China and recorded on the Form 3025, thus eliminating the requirement to file an I-693..

 

If you decide to have the vaccinations administered in the USA, it is common knowledge that the shots are cheaper in the local health department than they will be in the private practice office of the civil surgeon. Our local health department gets its vaccines from a company which makes no charge for the vaccine if it is for a non-US-citizen with an income of less than $40,000 per year, making the health department an even better option for us, as long as my fiancée gets the shots before we get married.

 

But neither the health department or the civil surgeon can know which sections of the I-693 must be filled out, because the instructions are contradictory and not even the USCIS knows how to resolve the contradictions. First of all, I present my guide as to how to call the USCIS and speak to an actual person. This guide applies only to questions about forms which are not specific to a particular case, and refers to menu options which are current as of August 2012. As you know, menu options tend to change.

 

1. Dial the USCIS numer 1-800-375-5283.

2. English-1 Spanish-2

3. filed electronically-1 all others-2

4. Press 0 if you came to the USA as a child and… etc.

5. Now comes the main menu

skip options 1,2,3

choose Option 4: Field Office or Application Support Center

6. next item: choose option 2: Application Support center

7. enter your zip code

8. you entered XXXXX, if that is correct, press 1

9. then they give you the address of the local application support center

10. next option: to hear more info about the application support center: yes, press 1

11. next options offered: choose option 6, "other questions", and you will be connected with a human being!!

12. they ask if you have a case pending (say no if you haven't filed yet), they ask another question, and then you are free to talk.

13. I have spoken to three agents so far. They have all been patient and friendly. But they could not resolve the contradictions in the forms, instructions and website.

 

The only suggestions I was left with from USCIS were "get an info-pass appointment with the local field office and try to resolve the issue there", or to go to the civil surgeon and see if he is one of those few who are willing to sign that he has performed the medical examination.

 

In the following summary of the contradictions and unclear places in the forms I refer to the Form I-693 dated 10/11/11, the instructions for that form dated 10/11/11 and the fifty-page Customer Service Handbook of the USCIS found at http://www.uscis.gov.../File_Forms.pdf

(I had never seen this link until today).

 

In a nutshell, the problems are:

 

1. The instructions (top of right column, page 4) say that a K-visa applicant for AOS with completed medical exam in China but arriving in the US with incomplete vaccinations is required to have the vaccination report completed by a designated civil surgeon and to submit the vaccination report and page 1 of form I-693 with the application for AOS.

 

2. Page 4 of the above-linked USCIS Customer Service Handbook states "When you submit your I-485 application, you will need to submit completed Parts 1, 2, and 5 of the Form I-693". If this sentence had just said "Parts 1, 2 and 3", then it would have been in agreement with the form instructions, since page one of the form contains parts 1, 2 and 3.

 

3. Page 7 of the handbook states: "If you are not required to undergo the entire medical exam, you need to submit only Parts 1 and 2, and either 5 or 6, depending on whether the vaccinations were administered by a local health department or a civil surgeon."

 

4. But then Page 7 states "Part 6 is only necessary to be completed for individuals who are filing based on refugee status."

 

5. Form I-693 contains sections designated "Part 1, Part 2, and Part 3". After that comes the Civil Surgeon worksheet on pages 2, 3 and 4, which includes six sections, numbered 1 through 6. Finally, the Vaccination Record on page 5. There is no "Part 4", "Part 5" or "Part 6" on the form. All clear?

 

I searched the USCIS website for information and only got a page referring to the forms and requirements in the year 2008.

 

If my local civil surgeon insists on performing a second medical exam, I shall try to get an appointment at the nearest USCIS office and try to clarify the I-693 problem. Within the next few weeks I shall make a further report on this unsatisfactory situation.

[dnoblett]

Back in the day when my wife adjusted status, I simply brought I-485 directions and simply pointed out where it explicitly states that a full medical is NOT needed for a K-1 adjusting status, the doctor grumbled some and did the I-693 the way I requested transferring vaccination record from my wife's yellow book and charged us I believe $20. I believe at the time the med center in China was not in the habit of doing the DS-3025, or we would have don that instead of getting the yellow book, because she did her vaccinations at the medical center in China.

[Da Niao]

Thanks for mentioning the 485 instructions, Dan. They clearly state that no medical report is needed, and that you may include the vaccination supplement with your Form 485. The Instructions for Form 693 say that you are required to include the vaccination report with the application for AOS. On page five of the form itself it is called the vaccination record. So here are three designations for what is probably (hopefully) the same thing. :-)

[Randy W]

Thanks for mentioning the 485 instructions, Dan. They clearly state that no medical report is needed, and that you may include the vaccination supplement with your Form 485. The Instructions for Form 693 say that IN THIS CASE you are required to include the vaccination report with the application for AOS. On page five of the form itself it is called the vaccination record. So here are three designations for what is probably (hopefully) the same thing. :-)

 

THIS CASE being that "the vaccination record (DS3025) was not properly completed and included as part of the original overseas medical examination report"

 

An exercise in semantics - yes, some of the language is carried over from a few years ago when the vaccination record/report/supplement was a separate USCIS (I-) form, and there are inconsistencies.

 

You may do better, though, to concentrate on the task at hand - which is to find a civil surgeon who is willing to sign off on only the vaccination report. Some people, for the sake of expediency, will simply go ahead and have the full exam repeated. Your choice.

Edited August 8, 2012 by Randy W (see edit history)

[Da Niao]

Trying to find some light in the darkness of conflicting instructions concerning civil surgeons and Form I-693, I called the USCIS Form Completion Help Desk twice. The first time, the agent said she would have to connect me to the next higher echelon of support, but that the computer connection was down, and would I please try again a few hours later. The next time I called, the agent who answered didn't know anything about a higher echelon of support, but he also could not resolve the conflicting instructions, so he advised me to get an Infopass appointment at the local regional USCIS office and discuss the matter there.

 

The Infopass system worked beautifully for us: it offered several appointments within the next few days, and we picked a suitable one. When we arrived at the Federal Building we discovered that instead of being twenty minutes early, we were ten minutes late, as I had made a mental note of the wrong time. It took us ten more minutes to get through security, get upstairs to the right room, put our appointment slip in the box, and have the box noticed by an agent. Since the SOP is that if you come late, you can lose your place in line and have to make another appointment, we were very relieved when my name was called shortly and I was able to discuss the issues face-to-face with a USCIS agent.

 

The luck of the draw — I talked to an agent who had no idea of the problems with civil surgeons, and the only advice I was able to get was just to go to some civil surgeon and make the best of whatever his interpretation of the requirements might happen to be. Which is what those of us who need the civil surgeon's signature have been doing all along, and what has led to the many threads and stories about the searches for civil surgeons who do not make unnecessary tests and excessive charges. I asked the agent if he would accept my written report about the problems and inconsistencies in the forms and on the USCIS website, to pass it along up the chain of command. He declined to take my report, but handed me a red card designed for USCIS feedback and suggested that I send the report to the address on the card.

 

The USCIS agent I talked to was an agent-in-training, one who staffs a window with a more experienced agent lurking behind him, with whom he exchanges whispered conversations after every question posed by a visitor. So you aren't really speaking directly to a USCIS agent who knows something, you are asking a trainee, who then presents his understanding of what you were asking to an invisible mentor on the other side of a curtain, and then you get the trainee's version of what his colleague tells him. This was very similar to my fiancée's interview in Guangzhou in June, at which the interviewer turned aside repeatedly and exchanged comments and chuckles with another agent sitting nearby.

 

This being the year of the trainee for us, we almost expected to have a trainee civil surgeon interviewing us when we went to a clinic in our area a few days later. Fortunately we encountered a real civil surgeon, one who was fully aware of the impossibility of ever understanding the forms and instructions in their present form, and who said that the best he or any civil surgeon could do was to muddle through in the most plausible way possible, send it in, and hope that it would be accepted without a Request For Evidence. He said that he had had RFE's when he was sure that everything was complete, and that forms had been accepted when he knew that they were not really in accordance with the wording of the instructions.

 

So he wanted to insert the blank pages 2, 3 and 4 of Form I-693 into the sealed envelope, but when I told him that the USCIS website guide said that pages which were not filled out could be omitted, he was willing to try leaving them out. He did not follow the instructions to the civil surgeons which said that a TB skin or blood test must be made, accepting the interpretation that that would be part of a medical examination which was not necessary because she had had the medical examination in Guangzhou. But how can the civil surgeon know what kind of an examination she had in Guangzhou? We had a single sheet of paper to show him, which did not mention a TB test, and showed only a single number as the entire results of blood testing. So the surgeon signed under penalty of perjury that he had performed "this examination", and gave us a sealed envelope which we will send off to the Chicago lockbox later this month. Charge was $66, and would have been $120 if he had performed the entire medical examination.

 

What he had done was to confirm that my fiancée had had three shots, and this is all that the USCIS will really find out upon receiving her Form I-485, since they will have no way of knowing, or finding out whether she ever gets the booster shots due in ten days and next February. Now we have to send in our packet of forms and wait either four months (with interview) or six months (without interview) for that green card, according to current timelines. Assuming the 693 is accepted.

[johnny206]

My wife went to Dr. Helen Quan in Seattle area. $50 to just sign off on the form and $160 for shots and blood work. My wife needed one booster shot so her total came to $110. Dr. Quan has all the forms and speaks Mandarin so that's a big bonus.

 

• Dr. Helen K Quan
  6517 35th Avenue S.W., Seattle, WA 98126
  (206) 937-1050

[Shenzhen K-1]

Physicians Immediate Care

Dr. Cynthia Frances Susedik

2496 Dekalb Avenue

Sycamore, IL, 60178

Get directions

815-754-1122

1- When did the wife's shots and -I693, no problems and charged $29.95 to sign the papers.

2- Son did shots at local health department and when went to go back to get the I-693 sigbed, we were told that he need a physical?

3- Next got a call that our paper work was ready, no apology but no charge, lol!

[johnny206]

Seattle area doctor to avoid...

 

My wife and I just had our AOS interview and we did not get approved on the spot because my civil surgeon had missing pages in the vaccinations form. Now I have to go back and resend a completed form to be approved. I would avoid the surgeon I used, Helen K. Quan, if possible to prevent unnecessary delays.