[Federal Register Volume 76, Number 176 (Monday, September 12, 2011)]
[Notices]
[Page 56271]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-23254]


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DEPARTMENT OF STATE

[Public Notice: 7578]


30-Day Notice of Proposed Information Collection: Forms DS-1622, 
DS-1843, DS-1622P and DS-1843P: Medical History and Examination for 
Foreign Service

ACTION: Notice of request for public comments.

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SUMMARY: The Department of State is seeking Office of Management and 
Budget (OMB) approval for the information collection described below. 
The purpose of this notice is to allow 60 days for public comment in 
the Federal Register preceding submission to OMB. We are conducting 
this process in accordance with the Paperwork Reduction Act of 1995.
     Title of Information Collection: Medical History and 
Examination for Foreign Service.
     OMB Control Number: 1405-0068.
     Type of Request: Revision of Currently Approved 
Collection.
     Originating Office: Office of Medical Services, M/MED/C/
MC.
     Form Number: DS-1622, DS-1843, DS-1622P, and DS-1843P.
     Respondents: Foreign Service Officers, State Department 
Employees, Other Government. Employees and Family Members of Foreign 
Affairs Agencies.
     Estimated Number of Respondents: 8,000 per year.
     Estimated Number of Responses 8,000 per year.
     Average Hours per Response: 1.0 hours per response.
     Total Estimated Burden: 8,000 hours.
     Frequency: On occasion.
     Obligation to Respond: Mandatory.

DATES: The Department will accept comments 30 days from date of in the 
Federal Register.

ADDRESSES: Direct comments to the Department of State Desk Officer in 
the Office of Information and Regulatory Affairs at the Office of 
Management and Budget (OMB). You may submit comments by any of the 
following methods:
     E-mail: [email protected]. You must include the 
DS form number, information collection title, and OMB control number in 
the subject line of your message.
     Fax: 202-395-5806

FOR FURTHER INFORMATION CONTACT: Direct requests for additional 
information regarding the collection listed in this notice, including 
requests for copies of the proposed information collection and 
supporting documents, to Department of State, Office of Medical 
Clearances, SA 15 A 1800 North Kent St. Rosslyn, Virginia 22209 (ATTN: 
Barbara Mahoney), who may be reached at 703-875-5413 or 
[email protected].

SUPPLEMENTARY INFORMATION: 
    We are soliciting public comments to permit the Department to:
     Evaluate whether the proposed information collection is 
necessary for the proper performance of our functions.
     Evaluate the accuracy of our estimate of the burden of the 
proposed collection, including the validity of the methodology and 
assumptions used.
     Enhance the quality, utility, and clarity of the 
information to be collected.
     Minimize the reporting burden on those who are to respond, 
including the use of automated collection techniques or other forms of 
technology.

Abstract of Proposed Collection

    Form DS-1622(P) and DS-1843(P) are designed to collect medical 
information to provide medical providers with current and adequate 
information to base decisions on medical suitability of a Foreign 
Service Officer or other federal employee and family members for 
assignment abroad. All forms will allow medical personnel to verify 
that there are sufficient medical resources at a diplomatic mission 
abroad to maintain the health and fitness of the individual and family 
members within the Department of State medical program.

Methodology

    The information collected will be collected through the use of an 
electronic forms engine or by hand written submission using a pre-
printed form.

    Dated: August 3, 2011.
Joseph A. Kennedy,
Executive Director, Office of Medical Services, Department of State.
[FR Doc. 2011-23254 Filed 9-9-11; 8:45 am]
BILLING CODE 4710-36-P