Information Collection

NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement

IC 249896 under ICR 202110-3150-001 · OMB 3150-0249.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3150-0249 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NRC Form 798 NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement	Form and Instruction
NRC Form 798 Request for a Medical Exception to the COVID-19 Vaccine NRC Form 798.pdf	Form and Instruction
NRC Form 798 Request for a Medical Exception to the COVID-19 Vaccine NRC 798 (Draft 6) (11-05-2021).pdf	Form and Instruction

IC Title:

NRC Form 798, Request for a Medical Exception to the COVID-19 Vaccination Requirement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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 and Instruction	NRC Form 798	Request for a Medical Exception to the COVID-19 Vaccine Requirement	NRC 798 (Draft 6) (11-05-2021).pdf		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

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.