Information Collection

Medical Screening of Military Personnel

IC 5500 under ICR 201003-0704-013 · OMB 0704-0413.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0413 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 2807-1 Medical Screening of Military Personnel	Form
DD Form 2807-1 Report of Medical History dd2807-1.pdf	Form
DD Form 2807-2 MEDICAL PRESCREEN OF MEDICAL HISTORY REPORT dd2807-2.pdf	Form and Instruction

IC Title:

Medical Screening of Military Personnel

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 2807-1	Report of Medical History	dd2807-1.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	DD Form 2807-2	MEDICAL PRESCREEN OF MEDICAL HISTORY REPORT	dd2807-2.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 850,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	850,000	0	850,000
Annual IC Time Burden (Hours)	135,833	0	135,833
Annual IC Cost Burden (Dollars)	1,047,291	285,521	761,770

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.