Information Collection

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

IC 249896 under ICR 202203-3150-004 · OMB 3150-0249.

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 798 for OMB submission.pdf	Form and Instruction

IC Title:

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 and Instruction	NRC Form 798	Request for a Medical Exception to the COVID-19 Vaccine Requirement	NRC 798 for OMB submission.pdf		Yes	Yes	Fillable Fileable

Line of Business: Energy

Subfunction: Energy Production

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	-40	50
Annual IC Time Burden (Hours)	5	-20	25
Annual IC Cost Burden (Dollars)	0	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.