All Adjustment of Status applicants are required to submit a completed I-693, Report of Medical Examination and Vaccination Record signed by a USCIS-designated civil surgeon. Generally, the I-693 cannot be signed more than 60 days before the applicant files the I-485 Application to Register Permanent Residence or Adjust Status with USCIS. 

In December 2021, USCIS initially announced that it was temporarily waiving the 60-day signing requirement for I-693s. A second announcement was made on September 29, 2022 extending the waiver through March 31, 2023. 

This allows Adjustment of Status applicants to use medical exams signed more than 60 days before submission. It is still recommended to obtain your medical exam as close to submission as possible, or after submission, in order to avoid needing to redo the medical exam. All medical exams continue to remain valid only for two years from the date of signature.