Recently, USCIS has started sending courtesy notices regarding the I-693 medical exam.   The USCIS notice advises that as of September 30, 2021 the USCIS medical exam will be valid for 2 years from the date the civil surgeon signs the medical exam as long as the medical is either (1) filed with USCIS within 60 days of obtaining the medical, or (2) the medical exam is signed after the I-485 application is filed with USCIS.  USCIS had temporarily extended the validity of the I-693 medical exam from 2 years to 4 years, but the temporary extension is expiring as of September 30, 2021.  Additionally, starting October 1, 2021, USCIS will require proof of COVID vaccination as part of the I-693 medical examination process. We are advising clients who have not already submitted their medical exams to USCIS, to wait until USCIS issues the Request for Evidence (RFE) specifically asking for the medical exam before obtaining a medical exam from a designated Civil Surgeon.