[Federal Register Volume 82, Number 57 (Monday, March 27, 2017)]
[Notices]
[Pages 15266-15267]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-05950]


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DEPARTMENT OF STATE

[Public Notice: 9780]


60-Day Notice of Proposed Information Collection: Medical History 
and Examination for Foreign Service

ACTION: Notice of request for public comment.

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SUMMARY: The Department of State is seeking Office of Management and 
Budget (OMB) approval for the information collection described below. 
In accordance with the Paperwork Reduction Act of 1995, we are 
requesting comments on this collection from all interested individuals 
and organizations. The purpose of this notice is to allow 60 days for 
public comment preceding submission of the collection to OMB.

DATES: The Department will accept comments from the public up to May 
26, 2017.

ADDRESSES: You may submit comments by any of the following methods:
     Web: Persons with access to the Internet may comment on 
this notice by going to www.Regulations.gov. You can

[[Page 15267]]

search for the document by entering ``Docket Number: DOS-2016-0073'' in 
the Search field. Then click the ``Comment Now'' button and complete 
the comment form.
     Email: [email protected].
     Regular Mail: Send written comments to: Office of Medical 
Clearances, SA-15 Room 400, 1800 North Kent St., Rosslyn, VA. 22209.
     Fax: 703-875-4850.
You must include the DS form number (if applicable), information 
collection title, and the OMB control number in any correspondence.

FOR FURTHER INFORMATION CONTACT: Direct requests for additional 
information regarding the collection listed in this notice, including 
requests for copies of the proposed collection instrument and 
supporting documents, to Joan F. Grew who may be reached on 703-875-
5412 or at [email protected].

SUPPLEMENTARY INFORMATION: 
     Title of Information Collection: Medical History and 
Examination for Foreign Service.
     OMB Control Number: 1405-0068.
     Type of Request: Revision of a Currently Approved 
Collection.
     Originating Office: Bureau of Medical Services--Medical 
Clearances Department.
     Form Numbers: DS-1843 and DS-1622.
     Respondents: Foreign Service applicants or employees or 
eligible family members.
     Estimated Number of Respondents: 7,814.
     Estimated Number of Responses: 7,814.
     Average Time per Response: 1 hour.
     Total Estimated Burden Time: 7,814 hours.
     Frequency: Upon Entry to Foreign Service and then 
intermittent, as needed.
     Obligation To Respond: Required to Obtain or Retain a 
Benefit.

    We are soliciting public comments to permit the Department to:

     Evaluate whether the proposed information collection is 
necessary for the proper functions of the Department.
     Evaluate the accuracy of our estimate of the time and cost 
burden for this 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 
information technology.

Please note that comments submitted in response to this Notice are 
public record. Before including any detailed personal information, you 
should be aware that your comments as submitted, including your 
personal information, will be available for public review.

Abstract of Proposed Collection

    Forms DS-1843 and DS-1622 collect medical history, lab tests and 
physical examination for employees and family members for the Foreign 
Affairs agencies, to include State, USAID, Foreign Commercial Service, 
Foreign Agricultural Service and Broadcasting Board of Governors. Forms 
DS-1843 and DS-1622 are designed to collect sufficient and current 
medical information on the individual in order for a medical provider 
to make a medical clearance determination for initial appointment to 
the Foreign Service. They are also used to determine whether a Foreign 
Service applicant, employee, or eligible family member will have 
appropriate medical and/or educational resources at a diplomatic 
mission/host country abroad to maintain the health and safety of the 
individual or family member.

Methodology

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

Behzad Shahbazian,
Director of Clinical Services, Bureau of Medical Services, Department 
of State.
[FR Doc. 2017-05950 Filed 3-24-17; 8:45 am]
 BILLING CODE 4710-36-P