[Federal Register Volume 82, Number 116 (Monday, June 19, 2017)]
[Notices]
[Pages 27942-27943]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-12624]


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DEPARTMENT OF STATE

[Public Notice 10030]


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

ACTION: Notice of request for public comment and submission to OMB of 
proposed collection of information.

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SUMMARY: The Department of State has submitted the information 
collection described below to the Office of Management and Budget (OMB) 
for approval. 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 
30 days for public comment.

DATES: Submit comments directly to the Office of Management and Budget 
(OMB) up to July 19, 2017.

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 the following 
methods:
     Email: [email protected]. You must include the 
DS form number, information collection title, and the OMB control 
number in the subject line of your message.
     Fax: 202-395-5806. Attention: Desk Officer for Department 
of State.

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.

[[Page 27943]]

    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. 2017-12624 Filed 6-16-17; 8:45 am]
 BILLING CODE 4710-36-P