[Federal Register Volume 85, Number 92 (Tuesday, May 12, 2020)]
[Notices]
[Pages 28134-28135]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-10083]


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DEPARTMENT OF STATE

[Public Notice: 11112]


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

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 July 
13, 2020.

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 search for the 
document by entering ``Docket Number: DOS-2020-0020'' in the Search 
field. Then click the ``Comment Now'' button and complete the comment 
form.
     Email: [email protected].
     Regular Mail: Send written comments to: Medical Director, 
Office of Medical Clearances, Bureau of Medical Services, 2401 E Street 
NW, SA-1, Room L-101, Washington, DC 20522-0101.
     Fax: 202-647-0292, Attention: Medical Clearance Director.

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, should be sent to Karl Field, Director of Medical 
Clearances at 202-663-1591 or [email protected].

SUPPLEMENTARY INFORMATION: 
     Title of Information Collection: Medical History and 
Examination.
     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: Contractors and eligible family members.
     Estimated Number of Respondents: 2,039.
     Estimated Number of Responses: 2,039.
     Average Time per Response: 1 hour.
     Total Estimated Burden Time: 2,039 hours.
     Frequency: Upon application for an overseas position 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

[[Page 28135]]

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 examinations for all individuals applying for overseas 
positions, including their eligible family members. 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 an overseas 
assignment. They are also used to determine whether the individual 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. The forms were 
updated to include questions regarding employment agency information 
for non-foreign service agencies. Once the collection instruments have 
been approved, the DS-1843/1622 can be used by respondents employed by 
both foreign and non-foreign service agencies, rendering the DS-6561 
form redundant. As a result, the DS-6561 would be discontinued upon OMB 
approval of the revised DS-1843 and DS-1622 forms.

Methodology

    The respondent will obtain the DS-1843 and DS1622 forms from their 
human resources representative or download the forms from a Department 
website. The respondent will complete and submit the forms offline.

Karl Field,
Director of Medical Clearances.
[FR Doc. 2020-10083 Filed 5-11-20; 8:45 am]
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