[Federal Register Volume 63, Number 240 (Tuesday, December 15, 1998)]
[Notices]
[Pages 69060-69061]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-33131]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Proposed Collection; Comment Request

AGENCY: Office of the Under Secretary of Defense (Personnel and 
Readiness), DoD.

ACTION: Notice.

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    In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995, the Office of the Under Secretary of Defense (Personnel 
and Readiness) announces the following proposed establishment of DD 
Form X376, ``Report of Medical History,'' a public information 
collection, and seeks public comment for the provisions thereof. 
Comments are invited on: (a) whether the proposed collection of 
information is necessary for the proper performance of the functions to 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of burden of the 
proposed information collection; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d)

[[Page 69061]]

ways to minimize the burden of the information collection on 
respondents, including use of automated collection techniques or other 
forms of information technology.

DATES: Consideration will be given to all comments received by February 
16, 1999.

ADDRESSES: Written comments and recommendations on the proposed 
information collection should be sent to the Office of the Under 
Secretary of Defense (Personnel and Readiness) (Force Management 
Policy) (Military Personnel Policy) /Accession Policy, ATTN: LTC 
Michael Ostroski, Room 2B271, 4000 Defense Pentagon, Washington, DC 
20301-4000.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection or to obtain a copy of the proposal and 
associated collection instruments, please write to the above address or 
call (703) 695-5529.
    Title, Associated Form, and OMB Number: ``Report of Medical 
History,'' DD Form X376, OMB Control Number 0704-[To be Determined].
    Needs and Uses: Title 10, USC Chapter 31: Section 504 and 505, and 
Chapter 33: Section 532, requires applicants to meet accession medical 
standards prior to enlistment into the Armed Forces (including the 
Coast Guard). If applicants' medical history reveals a medical 
condition that does not meet the accession medical standards, they are 
medically disqualified for military entrance. This form also will be 
used by all Service members not only in their initial medical 
examination but also for required periodic medical examinations.
    Affected Public: Individuals or households
    Annual Burden Hours: 256,659
    Number of Respondents: 330,000
    Responses Per Respondent: 1
    Average Burden Per Response: .66 hours per respondent.
    Frequency: One time.

SUPPLEMENTAL INFORMATION:

Summary of Information Collection

    The new form associated with this information collection will 
replace the form currently used by the Department, ``SF 93--Report of 
Medical History.'' This new form is needed in order to obtain the 
medical information which affects entrance physical examinations, 
routine in-service physical examinations, separation physical 
examinations, and other medical examinations, as required.
    The respondents are all applicants for enlistment, induction or 
commissioning. The applicant(s) completes the medical history 
information recorded on the form. This information collected provides 
the Armed Services with the medical history of applicants. The DD Form 
X376 is the method of collecting and verifying medical data on 
applicants applying for entrance. This DD Form X376 will be the 
official DoD medical document used by the Services through which 
historical medical information is collected, reviewed, and maintained.

    Dated: December 9, 1998.
Patricia L. Toppings,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 98-33131 Filed 12-14-98; 8:45 am]
BILLING CODE 5000-04-M