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BasicMed Comprensive Medical Examination Checklist
Alternative Pilot Physical Examination and Education Requirements (BasicMed)
OMB: 2120-0770
IC ID: 226106
OMB.report
DOT/FAA
OMB 2120-0770
ICR 202003-2120-003
IC 226106
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0770 can be found here:
2023-04-19 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 8700-2
BasicMed Comprensive Medical Examination Checklist
Form and Instruction
8700-2 BasicMed Comprehensive Medical Examination Checklist
FAA Form 8700-2 - BasicMed Comprehensive Medical Examination Checklist.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
BasicMed Comprensive Medical Examination Checklist
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
8700-2
BasicMed Comprehensive Medical Examination Checklist
FAA Form 8700-2 - BasicMed Comprehensive Medical Examination Checklist.docx
TBD
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Air Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
12,500
0
0
-441,493
0
453,993
Annual IC Time Burden (Hours)
9,375
0
0
-149,523
0
158,898
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.