[Federal Register Volume 86, Number 72 (Friday, April 16, 2021)]
[Notices]
[Pages 20130-20131]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-07828]


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DEPARTMENT OF DEFENSE

[Docket ID: DoD-2021-HA-0023]


Proposed Collection; Comment Request

AGENCY: The Office of the Assistant Secretary of Defense for Health 
Affairs, Department of Defense (DoD).

ACTION: Information collection notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Defense Health Agency announces a proposed public information 
collection and seeks public comment on the provisions thereof. Comments 
are invited on: Whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information shall have practical utility; the 
accuracy of the agency's estimate of the burden of the proposed 
information collection; ways to enhance the quality, utility, and

[[Page 20131]]

clarity of the information to be collected; and ways to minimize the 
burden of the information collection on respondents, including through 
the use of automated collection techniques or other forms of 
information technology.

DATES: Consideration will be given to all comments received by June 15, 
2021.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
    Federal eRulemaking Portal: http://www.regulations.gov. Follow the 
instructions for submitting comments.
    Mail: The DoD cannot receive written comments at this time due to 
the COVID-19 pandemic. Comments should be sent electronically to the 
docket listed above.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal Register document. The 
general policy for comments and other submissions from members of the 
public is to make these submissions available for public viewing on the 
internet at http://www.regulations.gov as they are received without 
change, including any personal identifiers or contact information.

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 Office of 
Information Management; 4800 Mark Center Drive, Suite 03F09, 
Alexandria, VA 22311; ATTN: Ms. Angela Duncan or call 571-372-7574.

SUPPLEMENTARY INFORMATION: 
    Title; Associated Form; and OMB Number: COVID-19 Vaccine Screening 
and Immunization Documentation; DHA Form 207; OMB Control Number 0720-
0068.
    Needs and Uses: The Defense Health Agency (DHA) has created the DHA 
Form 207, ``COVID-19 Vaccine Screening and Immunization Documentation'' 
to determine if the COVID-19 vaccine can be administered to a patient. 
The DHA Form 207 is used to determine and document patient eligibility 
and vaccine declinations for a COVID-19 vaccination. Respondents 
include Active Duty military members, Federal employees, beneficiaries, 
and contractors (based on their employment) who wish to receive the 
vaccine.
    Affected Public: Individuals or households.
    Annual Burden Hours: 1,500,000.
    Number of Respondents: 9,000,000.
    Responses per Respondent: 1.
    Annual Responses: 9,000,000.
    Average Burden per Response: 10 minutes.
    Frequency: On occasion.

    Dated: April 13, 2021.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2021-07828 Filed 4-15-21; 8:45 am]
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