Electronic Medical Examination for Visa Applicant

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-7794 Electronic Medical Examination for Visa Applicant	Form and Instruction	New	Missing upstream
Form DS-7794 Electronic Medical Examination for Visa Applicant	Form	Unchanged	Repair queued
(004) Tab 3 -- Legal Authorities 30 Day PRA -- eMedical.docx	Supplementary Document	Uploaded 2022-07-21	Missing upstream
Emergency Approval -- OIRA Letter -- Afghan Parolees.docx	Supplementary Document	Uploaded 2022-01-06	Repair queued
Legal Authorities.docx	Supplementary Document	Uploaded 2022-01-06	Repair queued
(003) Tab 2 -- Supporting Statement 30 Day PRA -- eMedical.docx	Supporting Statement A	Uploaded 2022-07-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
254784	Electronic Medical Examination for Visa Applicant	Form and Instruction	New
229467	Electronic Medical Examination for Visa Applicant	Form	Unchanged

ICR Details

OMB Control No: 1405-0230	ICR Reference No: 202207-1405-005
Status: Received in OIRA	Previous ICR Reference No: 202201-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Electronic Medical Examination for Visa Applicant
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/21/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2022
Responses	1,160,660	580,330
Time Burden (Hours)	580,330	580,330
Cost Burden (Dollars)	261,148,500	261,148,500

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Abstract: The eMedical system serves as a conduit from panel physicians to submit medical exam information to the Department and CDC. The medical forms are essential for determining the eligibility of aliens seeking immigrant or nonimmigrant visas to enter the United States.

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Authorizing Statute(s): US Code: 8 USC 1101 Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1201(d) Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1182(a)(1) Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1882 (d)(5) Name of Law: Immigration and Nationality Act
   US Code: 8 USC 1202(f) Name of Law: Immigration and Nationality Act
   US Code: 42 USC 264
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 11703	04/21/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 11791	07/20/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Electronic Medical Examination for Visa Applicant	DS-7794	Electronic Medical Examination for Visa Applicant
Electronic Medical Examination for Visa Applicant	DS-7794	Panel Physician Report on Medical Examination and Vaccination Record

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,160,660	580,330	0	580,330	0	0
Annual Time Burden (Hours)	580,330	580,330	0	0	0	0
Annual Cost Burden (Dollars)	261,148,500	261,148,500	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,305,742

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/21/2022

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