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

NRC Form 798, “Request for a Medical Exception to the COVID-19 Vaccine Requirement"

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.